Wachter's World

Is it “Macaca” Time in Healthcare?

Bob Wachter — Tue, 19 Aug 2008 07:00:00 GMT

August 11th was the 2nd anniversary of the epic implosion of George Allen's presidential campaign, the first defeat at the hands of YouTube. Two recent videos of unattended patients dying in ER waiting rooms leave me wondering whether healthcare has also...(read more)

Post-Vacation Potpourri: Items Interesting, International, and Ineffably Sad

Bob Wachter — Thu, 14 Aug 2008 02:07:00 GMT

Just returning from a work-acation, including a talk in Buenos Aires. Today I’ll briefly cover a few items: Medicare’s final “no pay” list; patient safety in Argentina; a great post on hospital finances; and one of the saddest things I’ve ever experienced....(read more)

Is “Patient-Centeredness” a Healthcare MacGuffin?

Bob Wachter — Mon, 04 Aug 2008 03:16:00 GMT

Last week’s ABIM Foundation Summer Forum focused on patient-centered care… and who could be against that? But is patient-centered care just a healthcare MacGuffin? What’s a MacGuffin, you ask? In a spectacular talk at the Forum, Michael Richardson of...(read more)

Will Knols and Blogs Upend the Cozy World of Medical Publishing?

Bob Wachter — Fri, 25 Jul 2008 05:03:00 GMT

Yesterday, Google launched Knol, immediately branded as Google’s answer to Wikipedia. As healthcare advisor to the project, I’ll say a few words about Knol, but focus on how it – and other forms of electronic self-publishing – may signal the end of medical...(read more)

The Long Awaited Crisis in Primary Care: It’s Heeere!

Bob Wachter — Sun, 20 Jul 2008 18:36:00 GMT

I recently heard from a UCSF physician who was flabbergasted when he sought an appointment in our general medicine practice and was told it was “closed.” Turns out we’re not alone: there are also no new PCP slots available at Mass General. The primary...(read more)

Another Case of Wrong Site Surgery: Are We Averting Our Eyes From Some of the Root Causes?

Bob Wachter — Wed, 09 Jul 2008 06:52:00 GMT

Yet another case of wrong-side surgery, this one at Boston’s Beth-Israel Deaconess Hospital. Though CEO Paul Levy does a nice job discussing the case on his blog, I’ll focus on two aspects Paul neglects: the role of production pressures in errors, and...(read more)

Door to Antibiotics Time in Pneumonia: Lessons from a Flawed Quality Measure

Bob Wachter — Wed, 02 Jul 2008 07:09:00 GMT

In today’s Annals of Internal Medicine, my colleagues and I describe the saga of the four-hour measure of door-to-antibiotics time for pneumonia – the first truly dangerous measure in the era of public quality reporting. It is an important cautionary...(read more)

The New (CMO) Math: Passion + Power = Progress

Bob Wachter — Wed, 25 Jun 2008 07:36:00 GMT

In his five years on the job, Dr. Ernie Ring taught me why the Chief Medical Officer role is crucial, and how to do it right. Since Ernie is retiring at week’s end, it seems like an opportune time to share what I’ve learned.A bit of background. UCSF Medical...(read more)

The Best and Worst of Times For “Infection Preventionists”

Bob Wachter — Mon, 23 Jun 2008 04:51:00 GMT

As I mentioned in my last post, these should be the best of times for "Infection Preventionists" (formerly known as Infection Control Officers). After years of trying to get someone – anyone – to pay attention to their work, their day in the sun has finally...(read more)

How Infection Prevention Came to Dominate the Patient Safety Movement

Bob Wachter — Sun, 22 Jun 2008 00:10:00 GMT

The Joint Commission just released its 2009 National Patient Safety Goals, and – no surprise – they focus on infection prevention. While this seems natural today, it wasn’t always so. In fact, the conflation of infection control and patient safety is...(read more)

Announcing our Hospitalist CME Course, and a New Hospitalist Mini-College

Bob Wachter — Sun, 15 Jun 2008 18:51:00 GMT

A quick heads-up for those of you thinking about attending this year’s Management of the Hospitalized Patient (MHP) conference, October 23-25 in SF… we’re adding a hands-on, small group “Hospitalist Mini-College” pre-course. I think it will be tremendous....(read more)

Could Intensivists Be Harmful to ICU Patients’ Health?

Bob Wachter — Wed, 04 Jun 2008 06:34:00 GMT

Of all the structural (how care is organized) “evidence-based markers of high quality care,” perhaps the most ironclad has been the involvement of critical care physicians in the care of ICU patients. That is, until now. In a sophisticated study in today’s...(read more)

Why Diagnostic Errors Don’t Get Any Respect… And What Can Be Done About It

Bob Wachter — Mon, 02 Jun 2008 03:20:00 GMT

I gave a keynote yesterday to the first-ever meeting on “Diagnostic Error in Medicine.” I hope the confab helps put diagnostic errors on the safety map. But, as Ricky Ricardo would say, the experts and advocates in the audience have some ‘splainin’ to...(read more)

The Funniest Satire on Interoperability You've Ever Seen (Trust Me)

Bob Wachter — Thu, 29 May 2008 07:54:00 GMT

There is nothing better than a good satire to capture certain (uncomfortable) truths – just ask any of the presidential candidates after an episode of Saturday Night Live. So check out this hilarious spoof on information technology interoperability. As...(read more)

Google Health: A View From the Inside

Bob Wachter — Thu, 22 May 2008 15:24:00 GMT

Google Health launched on Monday, which sent the world’s Google-watchers into a tizzy. I serve on Google Health's Advisory Council – which met all day Tuesday – and so here’s a bit of inside dish, along with my impressions of the site and the company....(read more)