@ Chris Kapsa
You have misspelled the co. name. For the record and your surfing convenience, it is really http://fresenius.com/

I am at a loss to know the way out, but I do know that competition for that little $5000 hospice benefit offered by Medicare (or whatever it is) is driving the wrong kind of results. Just a couple weeks ago I heard a story form a friend that his father-in-law was in a residential hospice setting and they had the nerve to call and tell someone in the family that they were not prepared to keep anyone unless they had less than two weeks to live. That, of course, is not legal and the person was prepared to take legal action against the hospice company, but the man did, in fact, soon die.

All this is “anecdotal” as are your and Christine’s stories. But there is more here than meets the eye, and as you said, the profession needs to remember what it’s here to do.

Far, far too few people understand the implications of your insightful post. Too many ‘histories’ of how effective innovations get adopted are “just so” stories. That almost never is how it really happened. The “anthropology” of how new stuff becomes the stuff we do is really important, & seldom replicable from a formula; and that’s hard news for the algorithm-bedazzled.

I am a sucker for smart physicians writing passionately and well about their craft as both Drs. Gawande and Wachter do here. I also love the essentially optimistic outlook—Dr. Gawande observes that care is “massively better” these days. We all sincerely hope that’s the case. It’s of course hard to argue with advice that we should focus on our values and the basic simple steps—but first things first.

Like some readers though I do wonder if we’re as radically patient-centered here as we might hope. For instance, I thought the closing lines about QS telling. “We’re here to alleviate suffering.” And thank God you are. Nevertheless, the point about QS is less about “we’re here to help you” and more about data empowering the everyman and woman to help themselves.

Cheers for an awesome read

Indeed.

I’m sure there are compelling arguments for and against EHRs but your ad hominem attack on these two men is way out of line. That comment embarrasses me on your behalf. You have reading and homework to do.