NY Times Magazine on Brent James’ Quest to Transform Healthcare Quality

By  |  November 5, 2009 | 

Just a quick heads up on an article in next weekend’s New York Times Sunday Magazine by my friend David Leonhardt. David profiles Intermountain Healthcare’s Brent James, capturing Brent’s (and Intermountain’s) unique and increasingly influential philosophy of using performance data to catalyze physician practice change. ??

The piece, which deftly highlights the tension between “cookbook medicine” and clinical intuition, is destined to become another classic in the growing lay-oriented literature that describes how quality and safety can be promoted in medicine. Like my two other favorites in this genre (both New Yorker pieces by Atul Gawande, focused on the work of Don Berwick and Peter Pronovost), it profiles an iconoclastic optimist  – which just shows that this work is so hard, the payment incentives so perverse, and the cultural forces so daunting that you really need a Kevlar-wearing, bullheaded, saintly genius to get it done.



  1. James November 5, 2009 at 11:12 pm - Reply

    It was indeed an excellent article.

  2. menoalittle November 6, 2009 at 4:30 am - Reply


    Interesting ideas and valid strategies but where have all of these results been published and are they reproducible? It is also a great plug for computerization, but with blogosphere reports and the recent questions about the HIT industry’s practices asked by Senator Grassley, including a letter to 3M, are the results reliable?

    On the skeptical side, I regret to point out that my enthusiasm for IHC’s mission, its integrity, and its medical care “results” has been tempered upon seeing the video of Harvard Law Professor and Obama appointee TARP Overseer reporting: in 2003, 3,000 families with catastrophic health events were forced into bankruptcy by the aggressive debt collection by this same “not for profit” medical care trendsetter and health policy lobbyist:


    And in the NY Times report:

    “Intermountain previously had negotiated a price reduction from the manufacturer that saved thousands of dollars on each device. But the hospital was still charging patients the old price, and the insurers, including Medicare, were still paying…. The finance executive replied, apologetically, that changing the reimbursement rate would cost Intermountain millions of dollars and that there did not seem to be any way to make up for the loss. The meeting then moved on to another topic.”

    Best regards,


  3. Josef Chemtob M.D. November 11, 2009 at 4:24 pm - Reply

    Not to take anything away from his results:

    He may get better results but doesn’t this feel like more and more marginalization. yes, the results are good, and more patients are safer, healthier, less morbidity, less mortality blah blah blah…in the end…more paperwrok (I’m sure).

    Am I the only one thinking this is making my job so much more BORING than I ever wanted it to be.

    sorry to bitch
    Josef Chemtob

  4. SandralpsRN December 2, 2009 at 4:03 am - Reply


    I am so happy to read that not every national media organization is buying the IHC model of greatness. Were they on the leading edge of the patient safety movement and standardization before most even considered it? Absolutely. Do they have great processes that my organization should emulate? Definitely. But, their quality staff is expressly forbidden to share with those outside of their organization. All of their policies are copywritten. My organization willingly shares policies and processes with anyone who asks.

    I would send anyone I know to their flagship hospital and would feel safe if I had to receive care there myself. However, I could never work for them because of their business practices. They almost lost their non-profit status because of their billing and collection practices. And I know from experience that if they can get away with sending patients who “flunk the wallet biopsy” to another organization, they will do so.

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About the Author:

Robert M. Wachter, MD is Professor and Interim Chairman of the Department of Medicine at the University of California, San Francisco, where he holds the Lynne and Marc Benioff Endowed Chair in Hospital Medicine. He is also Chief of the Division of Hospital Medicine. He has published 250 articles and 6 books in the fields of quality, safety, and health policy. He coined the term hospitalist” in a 1996 New England Journal of Medicine article and is past-president of the Society of Hospital Medicine. He is generally considered the academic leader of the hospitalist movement, the fastest growing specialty in the history of modern medicine. He is also a national leader in the fields of patient safety and healthcare quality. He is editor of AHRQ WebM&M, a case-based patient safety journal on the Web, and AHRQ Patient Safety Network, the leading federal patient safety portal. Together, the sites receive nearly one million unique visits each year. He received one of the 2004 John M. Eisenberg Awards, the nation’s top honor in patient safety and quality. He has been selected as one of the 50 most influential physician-executives in the U.S. by Modern Healthcare magazine for the past eight years, the only academic physician to achieve this distinction; in 2015 he was #1 on the list. He is a former chair of the American Board of Internal Medicine, and has served on the healthcare advisory boards of several companies, including Google. His 2015 book, The Digital Doctor: Hope, Hype, and Harm at the Dawn of Medicine’s Computer Age, was a New York Times science bestseller.


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