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 publishing as we have known it.First, a word about Knol (the name is short for “a unit of ...

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 care crisis has truly arrived. I’ve written about the roots of the problem previously, and won’t ...

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 Center didn’t have a Chief Medical Officer until about 8 years ago; indeed, even today ...

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. This will be our 12th Annual MHP conference (co-sponsored by the Society of Hospital ...

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 do.I date the origin of the patient safety field to the publication of the IOM report on medical ...

Today, Modern Healthcare released its yearly list of the 50 most influential physician-execs in the U.S. I have to believe that you, my readers, are at least partly responsible (along with my parents and their pals in Boca) for my #19 position, the highest rank of any full-time faculty physician. As nice as this is, I must admit that seeing ...

In this week’s JAMA, Dr. Don Berwick, CEO of the Institute for Healthcare Improvement, argues that evidence-based standards should be relaxed for quality improvement practices. Ironically, a few pages away, a Swiss study finds than an IHI-endorsed MRSA prevention strategy doesn't work.What’s a person or hospital to do?A little background on both ...

I must admit, I didn’t hold out high hopes that a ragtag band of committed clinicians and other quality improvers could change federal policy. But we’ve done just that. If the Feds are capable of rectifying this mistake, who knows what might be next!For those unfamiliar with the Hopkins-Michigan-OHRP checklist story, it is described on my prior ...

Thanks to all of you who have taken the time to write, blog, and rant about the OHRP's horrific decision to shut down the Hopkins-Michigan ICU checklist study, a decision that threatens the future of quality improvement and safety efforts in American healthcare. Today, the major hospital-based societies – representing over 100,000 clinicians and ...

In this month’s issue of the Joint Commission Journal of Quality and Patient Safety, I (with UCSF’s Adams Dudley and the American Hospital Association's Nancy Foster) tackle this provocative question. The answer may surprise you: yes (probably). The devil will be in the details.I hope you’ll have a chance to read the full article (the Joint ...