I’m on clinical service now and my patients are dying left and right. And I’ve never been prouder of my own care, and that delivered by my colleagues and hospital. When I was in training, a patient’s death was invariably considered a medical failure, and thus an occasion for shame and silence – the Outcome-That-Must-Not-Be-Named. We treated it ...

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 ...

My older son is gearing up to apply to college (:-\ and so I bought him one of the Bibles, the Fiske Guide. The book is cleverly written – enough academic factoids to get parents to spring for it, leavened with enough social scene skinny to get kids to read it. The Guide dutifully lists ranges of SAT scores for accepted applicants at 300 ...

So Zagat will now be rating doctors, using the methods it perfected helping you find the best sushi in Brooklyn Heights. What’s next, Consumer Reports rating grad schools? Fodor rating auto mechanics?Whatever you think of Zagat’s cross-dressing, it again demonstrates the bottomless market for doctor rankings. HealthGrades, the Colorado company ...

The comments to my original post on this topic are so striking and passionate that I wanted to answer them in a new post rather than as another comment. First, ''LPrieto'' wrote, ''I think the death of outpatient general Internal Medicine is inevitable.''  Then ''C33333'' wrote that 16/17 of his or her (hard to sort out the gender of people ...

A humorous and telling story about quality measurement, decision support, and human nature:I was visiting professor at a very good academic medical center a year or so ago. On these trips, one of the fun things I get to do is meet with the residents. Sometimes they present a clinical case to me, but this day they wanted to talk about healthcare ...