Career Leadership

Q&A with “The Digital Doctor”

Q&A Podcast with Dr. Bob Wachter, author of  The Digital Doctor.

What’s the biggest challenge facing patient safety?  In this podcast, Dr. Robert Wachter discusses the improvements made to patient safety in medicine over the past 16 years; how the new generation of doctors is changing clinical practice; and why a flattening of medicine’s traditional hierarchies will bring about better care.

Here’s an excerpt:

“When I was in med school, I learned precisely nothing about safety, about quality, about cost, about systems thinking, about teamwork. I went to a terrific med school, and I thought I had a great education when I came out. It was just, that was the state of the art. And we’ve learned that that’s wrong, and that students today – not just medical students but nursing students, pharmacy students, and other health professional students – need to be deeply comfortable with the science of safety and quality and improvement, and also need to truly understand that the role of the clinician – let’s take doctors for a moment – that the role of a doctor is not simply that you do the best job you can taking care of the patient in front of you. It has to have a component of: I am also a leader in the system in which I work; and therefore, I am constantly trying to make my system better, and that’s not only not a violation of Hippocratic oath; it’s an endorsement of the Hippocratic oath. It’s a recognition that for us to deliver high quality, safe, satisfying care to patients, it is as much about the quality of the system as about the quality of the individual. And you might say, ‘Okay, good. Somebody should fix the system.’ We’ve also learned you can’t fix the system if the people working in it don’t embrace that as a part of what they do.

There are lots of schools, including my own, that have completely revamped their curriculum, have built in robust educational components that relate to things like safety and quality and systems thinking and innovation. It’s tough because we haven’t lengthened the time for med school, and it’s not like the traditional scientific knowledge that we have to teach students is any less than it used to be. In fact, it’s grown as well.  I learned almost nothing about genetics, for example.

And so, we’re having to learn to teach in new ways, how to be more efficient, how to use modern tools to transmit knowledge, how to engage learners. And I think a lot of schools are doing that, recognizing that the old style of sitting in a lecture hall for eight hours a day, the old style of using dusty textbooks and going to the library and looking things up – that’s just not the way people learn today.  And so we have to embrace not only new curricular content, but new methodologies to make sure that people learn what they need to learn, and we treat them as adult learners.”

Robert Wachter is Professor and Chair of the Department of Medicine at the University of California San Francisco. Author of 250 articles he coined the term “hospitalist” in 1996 and is generally considered the “father” of the hospitalist field the fastest growing specialty in the history of modern medicine. He is past president of the Society of Hospital Medicine past chair of the American Board of Internal Medicine and a recipient of the Eisenberg Award the nation’s top honor in patient safety.


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