Posts by Bob Wachter

UCSF Benioff Children’s Hospital: A Tale of Great Leadership in Three Acts

This is an amazing tale of leadership – by my hospital CEO, our former chancellor, and, most importantly, a remarkable philanthropist. I’ll start with the latter, veer off to describe the former two, and then return, on this special day, to the philanthropist.The first time I met Marc Benioff – in 2007 – he was not a happy guy. A adult relative of his was hospitalized at UCSF, night had fallen, and Benioff – the billionaire founder of cloud computing pioneer Salesforce.com – was growing concerned about the slow pace of the workup and the seeming absence of Gray Beards there to supervise the trainees. I received a call from our dean, David Kessler, asking if I could help. I came into the hospital, spent some time discussing the case with Marc and his relative, and things went well.Over the next couple of days in the hospital, Marc asked me…

Announcing This Year’s UCSF Hospital Medicine CME Course and Hospitalist Mini-College

It’s that time again – here’s the brochure and course information for the Management of the Hospitalized Patient (MHP) conference, October 14-16 at the Fairmont Hotel in beautiful, fog-free (at least in October) San Francisco.This will be our 14th annual hospital medicine conference; the first, attended by about 100 hardy hospitalist pioneers and a few homeless folks wandering into a seedy downtown Holiday Inn, launched the National Association of Inpatient Physicians (which later became the Society of Hospital Medicine). SHM continues to co-sponsor the conference, which has grown bigger and better each year. As always, you can count on terrific teachers (I’m airlifting in a few more visiting profs this year, based on their stellar pedagogical reputations, to cover topics like acute MI, controversies in hospital cardiology, acute kidney injury, and acid-base disorders). We’ll also again use the computerized Audience Response System to promote active learning, and there are great…

Cheating on the ABIM Boards

As a member of the executive committee of the American Board of Internal Medicine, I can’t provide too much of the inside scoop, so I’ll mainly point you to the published descriptions of a remarkable case: that of one Dr. Arora, who ran an ABIM board review course with a difference. The difference was that attendees of the Arora Board Review were allegedly shown actual questions from past exams, fed to Dr. A from prior test takers – who shared dozens, and, in some cases, hundreds of questions. After a vigorous investigation, the board announced Wednesday that it has stripped scores of physicians of their board certification for periods ranging from 1-5 years. In addition, several other docs who hadn't completed the process yet were allegedly involved; they will not be allowed to sit for the boards for similar lengths of time. The total number of sanctioned physicians: 134.Meanwhile, the…

Dave Barry On “24” And Our Healthcare System

This past Monday was a sad night for me: no “24” on Fox, and no more installments in the works until the (inevitably disappointing) movie comes out. Watching Jack Bauer's derring-do with my sons has been one of my can’t-miss-it rituals for nearly a decade. I’m well aware that this cannot have been healthy, or moral, but it was exciting and, at times, awfully amusing.Over the last several years, one of the best parts of watching “24” was following along with Dave Barry’s “24 Blog”. Barry is one of the world’s most amusing fellows, and his running commentary each week on 24’s plot (such as it was) was hilarious. Here’s a sample from his post on the March 29th episode, one whose storyline was particularly ludicrous:The terrorists are transporting the Lethal Atomic Rods of Doom into Manhattan aboard an inflatable boat. Jack tried to stop them by engaging in a…

The Times Hits the Right Notes on Hospitalists

You probably saw yesterday’s hospitalist piece in the New York Times, arguably the best lay article on the movement to date. It hit all the right notes, and did so with uncommon grace and fairness. The piece, written by the Times’ Jane Gross, profiled Dr. Subha Airan-Javia, a young hospitalist at the Hospital of the University of Pennsylvania. While Dr. Airan-Javia spends about half of her time in administrative, largely IT-related roles (like many of my faculty), the article (and an accompanying profile) gave us a day in her life on the wards: seeing patients, collaborating with consultants, talking to families, and orchestrating discharges. The fundamental advantages of the hospitalist model – tremendous availability, markedly improved efficiency, and a unique focus on systems improvement – came through unambiguously. For example, regarding availability, there was this:Because she was on the floor all day, [she] was able to schedule a long meeting…
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