Robert Wachter, M.D.

Everyone had high hopes computers would be the magic bullet to improve the safety, quality and efficiency of healthcare. In the past five years – catalyzed by a $30 billion federal incentive program – medicine has finally, reluctantly, gone digital. Drawing from personal experiences and real-life case examples, Dr. Wachter explores some of the unforeseen consequences of information technology – including the movement to hire scribes so doctors and patients can look each other in the eye again, alert fatigue, and the tendency for clinicians to defer to a new kind of authority (an electronic one) – and discusses proposed solutions. He also touches on core issues in medicine, such as what it means to be a doctor – and patient – in the digital age, the theme of his recently published book of the same title (April 2015).

If there’s one thing most people inside and outside of healthcare can agree on, it’s that the American healthcare system is broken and must be fixed. Dr. Wachter reviews the brief history of the quality and safety movements, the new push for “value” (quality + safety + patient satisfaction divided by cost), and how all of these levers (accreditation, regulation, transparency, payment changes) are combining to create unprecedented pressure on caregivers and delivery organizations to change their ways of doing business. But for all of the pain, there is also hope: attendees will gain a deep understanding of healthcare’s evolving landscape and a roadmap (and some optimism) for success in this new world.

The title is a riff of a famous Seinfeld episode, one in which Jerry convinces his hapless friend George to try the opposite of his every instinct, but the topic has serious implications for physicians. In healthcare, physicians have been taught to be individualistic, to think about individual patients versus systems, to look outside their institution for answers, and not to consider resource allocation tradeoffs. Dr. Wachter talks about the imperative to move in new directions and provides some cautionary notes about what may be lost if the pendulum swings too far.

Dr. Wachter coined the term “hospitalist” in the New England Journal of Medicine in 1996. He describes the forces driving the growth of the field – the fastest-growing specialty in the history of medicine – and what’s to come. He also uses the case of hospitalists to discuss some key issues in healthcare innovation and change management.