Will the new resident duty hour rules improve patient safety?
by Bob Wachter, MD One of the mantras of performance improvement is that caregivers and provider organizations should learn from their experiences. That’s all well and good, but how about policy-setting organizations? Recently, in the New England Journal of Medicine , two of the Biggest Kahunas in the safety and quality worlds – the Joint Commission (TJC) and the Accreditation Council for Graduate Medical Education (ACGME) – announced bold new policies. To their credit, both organizations have learned from their experiences … and their mistakes. (...) Read the rest of Will the new resident duty hour rules improve patient safety? No comment | Tags: Hospital , Residency | Category: Medical education
The 80 hour resident work week balances fatigue and independence
by Danielle Ofri, MD, PhD How many hours can a doctor work? The residency regulators are back. About ten years ago, the national organization that accredits residency programs (ACGME) set out its first guidelines about how many hours a doctor-in-training can work. Interns and residents finally achieved the vaunted 80-hour workweek. New York State was 15 years ahead on this, having mandated an 80-hour work week in 1989, stemming from the Libby Zion case. (...) Read the rest of The 80 hour resident work week balances fatigue and independence No comment | Tags: Hospital , Residency | Category: Medical education
Categories: 2010, CCR, CES, General, HIE, VA Tags: 2010, CCR, CES, HIE, hospital, medical education, residency
Does prevention improve health care outcomes and lower costs?
by Joseph W. Stubbs, MD, FACP The eighth paragraph of the modern Hippocratic Oath reads: “I will prevent disease whenever I can, for prevention is preferable to cure.” Support and encouragement of prevention are deeply rooted among physicians. Intuitively, to prevent a deadly or disabling disease from occurring or stop it at an early stage seems like a bread-and-butter concept with obvious health benefits. But it should also accrue cost savings by avoiding the treatment of the disease and its complications. Indeed, prevention has been the mantra of many pundits and politicians during the past year’s debate on health care reform. Many have held out prevention as the touchstone of health care reform that would bring improved health care outcomes at lower costs. (...) Read the rest of Does prevention improve health care outcomes and lower costs? No comment | Tags: Health reform , Primary care | Category: Health policy and politics
Tort reform for doctors in exchange for less salary
by Jeffrey Parks, MD Matt Steinglass at The Economist has interesting take on tort reform, specifically that limiting physician liability for adverse patient outcomes must come with an equable cost to doctors. In Europe, the costs accrued due to medical errors are covered by the wide-ranging social safety net; the lottery system of massive medical malmalpractice judgments is virtually absent. It’s part of the social contract: doctors accept limited salaries in exchange for limited liability; patients accept that they cannot sue doctors for millions of dollars in exchange for a guarantee of access to decent health care. (...) Read the rest of Tort reform for doctors in exchange for less salary No comment | Tags: Health reform , Malpractice | Category: Health policy and politics
Categories: 2010, CCR, CES, Change, General, Patients Tags: 2010, CCR, CES, Change, health reform, malpractice, Patients
Residency team changes can improve education and patient care
by Bob Wachter, MD In the early 90s, I had the privilege of directing UCSF’s exceptional internal medicine residency program. It was a time of transition. A decade earlier, residency accreditation requirements (dictated by the Accreditation Council for Graduate Medical Education, ACGME) were fairly benign and largely ignored – marquee programs like ours were generally given carte blanche to organize our residents’ experience as we saw fit. (...) Read the rest of Residency team changes can improve education and patient care No comment | Tags: Hospital , Hospitalist , Residency | Category: Medical education