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 ...

My friend Mark Smith, who runs the California HealthCare Foundation, once wryly observed, “Have you ever noticed that the doctors who talk about how much fun primary care is only practice it one afternoon a week?” I may have become the hospitalist version of Mark’s Ivory Tower internists, but I’ll take my chances.I just finished a two-week stint ...

Great quote by USC cardiologist Leslie Saxon (a reporter reached her on her cell phone as Leslie was shopping) on this week’s NEJM study on delayed defibrillation: “You’re better off having your arrest [here] at Nordstrom [than in a hospital]… because there are 15 people around me.”You’ve probably seen the study, a detailed analysis of ...

Stuff this week that caught my eye: Does medical tourism harm the natives? Are all those CT scans destroying more than our budgets? Are nocturnalists at risk for more than decubs? Will Medicare need to cut hospital payments to fuel P4P? Answers: yes, yes, probably, and duh.Yesterday, NPR’s All Things Considered described the dark side of medical ...

Last year, I (with Peter Pronovost) wrote the toughest paper of my life – one that critiqued the Institute for Healthcare Improvement’s 100,000 Lives Campaign. This is the healthcare equivalent of criticizing both Mother Teresa and your local food bank in a single sitting (you can also read Don Berwick and his team’s response here). Although some ...

Sorry, but today is the day for a tiny bit of Shameless Commerce – a quick plug for my new book, Understanding Patient Safety. I wouldn’t normally do this – I’m as brazenly promotional as anybody, mind you, but it does seem a bit cheesy – but then I saw Robert Reich promote his new book on his blog. I really like Robert Reich, Clinton I’s Labor ...

Primary care is tanking. Job dissatisfaction is high, burnout is rampant, residents are voting with their feet in droves, and most primary care confabs have become sky-is-falling angst-a-thons. Since many people identify me as “the guy who invented hospitalists” (to which my stock reply is “just like Al Gore invented the Internet”), I have had ...