Category Archives: General Interest

What is Quality? It Depends on Who Does The Measurement

Posted on March 4, 2013 by Ted

There are more than a dozen sets of publicaly reported quality metrics … with between 8 & 80 individual components to each set. It is small wonder that they don’t agree. Continue reading →

Posted in General Interest | Tagged , , | 2 Comments

What is Evidence Based Medicine?

Posted on May 16, 2012 by Ted

One definition would be: Delivery of Medical Care based on results of best available evidence. This usually means finding or relying upon data, some of which will be from outside one’s immediate memory to help answer a clinical question. EBM … Continue reading →

Posted in effectiveness/efficacy, General Interest, Quality, treatment options | 2 Comments

Providers, Patient Care Delivery and Policy: Hospitalist story

Posted on August 24, 2011 by Ted

There are often perverse incentives in health care. These incentives can, at times, create competing drives where providers are encouraged to do things that directly increase the costs of care.  Consider the reaction to the mandate to cut down hours … Continue reading →

Posted in General Interest, Operational effectiveness, Policy, Quality | Tagged , , | 3 Comments

Why do Physicians Behave the Way They Do?

Posted on July 25, 2011 by Ted

I believe that the vast majority of physicians do “the right thing” for their patients. I don’t think I’m being a Pollyanna. On the other hand, the “The Tragedy of the Commons”, which describes behavior in many cultures, doesn’t bypass … Continue reading →

Posted in General Interest, Quality, treatment options | Tagged , , , | Leave a comment

Who worries about physician behavior? Who is ultimately responsible?

Posted on January 15, 2011 by Ted

There is a true story of a 30 yo woman who has a history of rheumatoid arthritis, and who developed unusual eye symptoms. She went to a physician who referred her to a neurologist (both were “independent medical practitioners”). The … Continue reading →

Posted in General Interest | 27 Comments

Who is responsible? Is there Enough Accountability in Medicine?

Posted on January 12, 2011 by Ted

The Alligator Allegory reads: “ The objective of all dedicated employees should be: To thoroughly analyze all situations, Anticipate all problems prior to their occurrence, Have answers for these problems, And Move swiftly to solve these problems when called upon. … Continue reading →

Posted in General Interest, Policy, Quality, Relevant Books | Tagged , | Leave a comment

Medical Ethics should address more than the individual patient encounter

Posted on December 22, 2010 by Ted

George Lundberg, reviewed what he called the Principles of medical ethics in his blog on  MedPageToday.com on December 20, 2010. He’s done us a service by bringing this up as the season for reflection is upon us. The AMA’s Code … Continue reading →

Posted in General Interest, Policy, treatment options | Tagged , | Leave a comment

What does the Patient Protection and Affordable Care Act (PP ACA; PL 111-148) say about Alignment?

Posted on October 26, 2010 by Ted

The PP ACA, stored as HR 3590 and signed into law on March 23, 2010, is 906 pages long. Most of the bill consists of amendments to other portions of the Laws of the United States as enumerated in the … Continue reading →

Posted in General Interest | Leave a comment

Are We Ready for Change in Our Systems?

Posted on October 10, 2010 by Ted

Innovation in any field involves change.  Medicine or health care is no exception.  However, not all change involves innovation. With the passage of the Patient Protection and Affordable Care Act (PL 110-148) in March of 2010 there will be change … Continue reading →

Posted in General Interest | Leave a comment