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 ...

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 ...

When I was a med student, the Beating Heart of the Hospital of the University of Pennsylvania (HUP) was not the CEO’s suite, the neurosurgeon’s OR, or the Dean’s lair. It was the seat of one Wallace Miller, Sr., in the decidedly unglamorous Chest Reading Room.Do you even know where the chest reading room of your radiology department is?Everybody – ...

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 ...