The Institute of Medicine just released its long-awaited report on trainee duty hours. It is well researched and balanced, and its recommendations appropriately reflect what we know vs. what we believe. Now the fun begins. Let’s start with a little background, some of it drawn from my book Understanding Patient Safety: Let’s be honest. ...

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 ...

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 ...

The patient safety and quality movements are precious and fragile. Just as IOM reports I and II spawned these modern, life-saving revolutions, the Federal shutdown of the Hopkins/Michigan checklist program may help extinguish them. After all, Tipping Points can tip both ways.I laid out the issues in this prior post. Those of you who know me know ...

As you may know, I’ve argued that that the quality and safety of healthcare have traditionally been underregulated. But regulators are like patients with Parkinson’s: it’s hard to get them unglued, but once they’re moving, it’s hard to stop them. Welcome to Exhibit A.Last month, I described Atul Gawande’s thrilling New Yorker article recounting ...

I've not been posting regularly on this story (as you might imagine, it's a bit tricky for me to do so), but for those following it from near and far (I've received emails from friends in Europe and Asia) there have been a number of interesting articles, including pieces in the LA Times, Washington Post, and SF Chronicle [some may require ...

Well, today the great Mecca of medical care and innovation that is UCSF all but ground to a halt. Our Dean was just let go under very odd circumstances, and everyone’s flocking to water coolers and Starbucks around the city to find out who knows what.I won’t be giving away any trade secrets here, since I have none. Lucky for me, I operate at an ...

The University of Pittsburgh Medical Center announced today that it will donate up to $100 million over the next decade to fund college scholarships for Pittsburgh public school students. This is a magnificent gesture, but it left me scratching my head: I thought hospitals were supposed to absorb charity, not dole it out.I already knew that Pitt ...