Academia

I left a pharma-sponsored research project. My reasons for doing so may be instructive.

  Not long back, I departed a pharma-sponsored research project.  I based my decision to leave in something I occasioned over a decade ago.  I thought it was time to share the episode and the lessons learned given the attention being paid to physician conflict of interest nowadays (as well as the annual Open Payments review and dispute period approaching). When I finished training, very few docs practiced hospital medicine—or even knew what the term hospitalist meant.  Several forward-thinking medical centers hitched their wagons to the hospitalist model, as did some astute information technology and staffing companies. However, few healthcare players embraced the hospitalist movement in a serious fashion like the pharmaceutical industry.  They realized hospitalists prescribed a narrow band of products, in big lots, within a centralized location.  The higher ups in the pharma sector saw the benefits in directing reps our way. Consistent with those goals, a physician…

Purge this Word Your Vocabulary. It’s Likely Harming Patients and Wasting Real Money.

  A little something I sent to my residents--and I post it here as the issue has relevance to every clinician.  Also, a wise professor offered me something to contemplate.  As you read, consider whether this is a professionalism OR systems issue.  If the latter, are the behaviors in accord with the signals we give our trainees, nocturnists and shift workers. Further, do we then have a system designed to provide us with the results we are asking for?  Scenario One: You walk into a bar, and you see a hot girl or guy. You think, "Hmm, I want to meet this person. Let me consider what to do next." Scenario Two: You have a car with a sluggish engine. Something is not right. Once again, you think, "I need to consider how to get the motor purring again." In both cases, everyone would agree you have some decisions to…

Prioritizing Inpatient Geriatric Care Is NOT a Moon Shot.

Most physicians recognize the JNC guideline for blood pressure management, or the ACCP thrombosis guideline for VTE.  Most would agree we use a handful of accepted benchmarks to manage a limited number of conditions.  For the rest, it’s the wild wild west. Try to develop consensus around delirium management or treatment of alcohol withdrawal, and you will likely find yourself on the road to nowhere. If you have never visited The National Guideline Clearinghouse, you should have a peek.  Sometimes I find the site helpful for a management dilemma or patient with a rare presentation. However, for most, the compilation runs endlessly long and you will begin a convoluted journey if you crave a solution.  The same road to nowhere. As of this writing, the database has close to 2400 entries.  Have fun with that: (more…)

Congratulations, Drs. Wachter, Conway and Murthy

Imagine for a minute that you’re Bob Wachter. Last week, you introduced your book to more than 3,000 hospitalists at Hospital Medicine 2015 on a Wednesday. Then, on Saturday, your photo is on the cover of Modern Healthcare and you find yourself at the top of the list of its top 50 most influential physician executives. [caption id="attachment_12310" align="alignright" width="150"] Dr. Wachter reading from his new book last week at Hospital Medicine 2015.[/caption] His rise to thought leadership isn't accidental. It’s the product of decades of commitment, insight and genuine compassion for hospitalized patients. And Dr. Wachter is not unique in his rise to national influence in healthcare. Hospitalists are trained and well suited to lead national efforts to improve patient care at all levels of our healthcare system. For the first time ever, three hospitalists – Drs. Wachter (number one), Patrick Conway (11) and Vivek Murthy (17) – were…

My Op-Ed in Today’s New York Times… and My New Book

This week feels like the coming out for my new book, The Digital Doctor: Hope, Hype, and Harm at the Dawn of Medicine’s Computer Age. The NY Times ran my op-ed on health IT today (they chose the slightly sensationalist title, FYI). I’ve also started something of a book tour, with several talks and media interviews scheduled this week, including a sit down with Sanjay Gupta. (Note to my wonderful children: sorry, no Jon Stewart; at least, not yet). Since the Times piece does not allow for comments, let me invite any comments here. The op-ed is really a Cliff’s Notes version of the book, whose formal publication date is April 7th but which began shipping from Amazon last week. If anyone would like to comment on the book, I’d love to hear that, too. (Of course, reviews of the book on Amazon are much appreciated, particularly if you liked…
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