High value, cost conscious care – the antithesis of too much care

Improving healthcare requires convincing insurers and Medicare to pay the right people appropriately for better outcomes.

Performance measurement – what has it wraught?

Performance measurement oversimplifies complex medical decision-making, leading to negative unintended consequences and undermining patient care quality.

Statins and fatigue

Patients often stop taking statins due to perceived side effects like decreased energy, despite improved cholesterol, challenging primary prevention strategies.

Avoiding the unintended consequences of the new work hours

This letter from residents appears in Academic Medicine – Unintended Consequences of Duty Hours Regulation

Avoiding the unintended consequences of the new work hours

Reducing 30-hour shifts has diminished doctor-patient bonds, reducing continuity of care and weakening critical doctor-patient relationships.

Sherlock on diagnostic errors

Masterpiece Theatre has just run the second 3 episode series of Sherlock – a modern retelling of Sherlock Holmes.

Why do we expect productivity from physicians

Challenging productivity in healthcare, this piece argues for valuing quality patient care over efficiency metrics like RVUs and time targets.

Has blogging helped my patients? #10yrsblog

Blogging has made me more thoughtful and well-read, but hasn’t directly helped my patients, just my perspective.

What explains blogging longevity? #10yrsblog

Thanks for gathering around while I scream at the injustices and praise the wonders of my most fortunate career.

Push back against “choosing wisely”

We should avoid excuses, and put our energies into making health care more affordable. And we should quit blaming the lawyers.