Posts by Bob Wachter

The ABIM Controversy: Where the Critics are Right, Where They’re Wrong, and Why I Feel the Need to Speak Out

“What’s up with the ABIM?” “I just got a note about an alternative board. Should I join it?” “Aren’t you glad to be off the Board?” These days, I get these questions from friends and colleagues regularly. When I first joined the board of directors of the American Board of Internal Medicine (ABIM) in 2004, the organization was a well-respected pillar of American medicine. Today the organization finds itself in a fight for its life, being painted as everything from out of touch to money-hungry to, more recently, corrupt. I just completed my decade-long service to the ABIM and, more recently, the ABIM Foundation. I’ve waited until now to write this because I wanted to be clear that I am not speaking for ABIM or its leadership. I am also well aware that there is a vocal group of critics who feel passionately about this matter, whose minds are made…

Is NLP-Enabled Data Mining the Digital Breakthrough We’ve Been Waiting For?

Natural language processing might seem a bit arcane and technical – the type of thing that software engineers talk about deep into the night, but of limited usefulness for practicing docs and their patients. Yet software that can “read” physicians’ and nurses’ notes may prove to be one of the seminal breakthroughs in digital medicine. Exhibit A, from the world of medical research: a recent study linked the use of proton pump inhibitors to subsequent heart attacks. It did this by plowing through 16 million notes in electronic health records. While legitimate epidemiologic questions can be raised about the association (more on this later), the technique may well be a game-changer. Let’s start with a little background. One of the great tensions in health information technology centers on how to record data about patients. This used to be simple. At the time of Hippocrates, the doctor chronicled the patient’s symptoms…

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…

My Interview With Capt. Sully Sullenberger: On Aviation, Medicine, and Technology

The story of Chesley “Sully” Sullenberger – the “Miracle on the Hudson” pilot – is a modern American legend. I’ve gotten to know Captain Sullenberger over the past several years, and he is a warm, caring, and thoughtful person who saw, in the aftermath of his feat, an opportunity to promote safety in many industries, including healthcare. In my continuing series of interviews I conducted for my upcoming book, The Digital Doctor: Hope, Hype, and Harm at the Dawn of Medicine’s Computer Age, here are excerpts of my interview with Sully, conducted at his house in San Francisco’s East Bay, on May 12, 2014. Bob Wachter: How did people think about automation in the early days of aviation? Sully Sullenberger:  When automation became possible in aviation, people thought, “We can eliminate human error by automating everything.” We’ve learned that automation does not eliminate errors. Rather, it changes the nature of…

My Interview With Health Policy Expert Mark Smith

Mark Smith, MD, MBA, was the founding CEO of the California HealthCare Foundation; he served in that role for 17 years before stepping down last year. I’ve known Mark since we were residents together at UCSF in the mid-1980s, and both of us were influenced by training at the epicenter of the AIDS epidemic. Mark continues to see AIDS patients at San Francisco General Hospital one day each week. He was the lead author of Best Care at Lower Cost, a major Institute of Medicine report, published in 2012. Mark is one of those rare people who can take complex and politically charged concepts and distill them into sensible nuggets – while managing to be hilarious and profound at the same time. In the continuing series of interviews I conducted for my upcoming book, The Digital Doctor: Hope, Hype, and Harm at the Dawn of Medicine’s Computer Age, here are…
12345...102030...