Zoom On: Robert W. Wachter MD

Robert W. Wachter, MD is Professor and Interim Chair of the Department of Medicine at the University of California, San Francisco, where he also directs the Division of Hospital Medicine. Author of 250 articles and 6 books, 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 and past chair of the American Board of Internal Medicine. In 2004, he received the John M. Eisenberg Award, the nation’s top honor in patient safety. In 2015, Modern Healthcare magazine ranked him as the most influential physician-executive in the U.S., his eighth consecutive year in the top 50. His 2015 book, The Digital Doctor: Hope, Hype and Harm at the Dawn of Medicine’s Computer Age, was a New York Times science bestseller. He is currently chairing a group charged by the UK’s Secretary of Health to advise the National Health Service on its digital strategy.

What are your key areas of interest and research?

I study complex health policy issues that have direct influence on clinical care. Over my career, these have varied — about every 5-7 years, I seem to find a new issue that I gravitate to. In retrospect, I see that the issues that grab me are ones with political, policy, economic, and ethical implications, but are relatively close to the ground — in other words, they impact the direct work of doctors and nurses as they take care of patients. I began my career studying HIV/AIDS and particularly the role of activism in shaping the response to that epidemic. I moved on to studying the organisation of hospital care and led the movement in the US to switch to the hospitalist model of care. I then became deeply involved in patient safety and health care quality. More recently, I've become fascinated by the consequences — intended and unintended — of the computerisation of healthcare.

What are the major challenges in your field?

Healthcare is changing rapidly, driven by greater pressures to delivery high value care (improved quality, safety, patient experience, all at a lower cost). This is healthy but it is highly disruptive. As an active clinician and clinical leader, I study these things but also have to try to practice in this environment and manage a large department through the storm. It's fascinating but a pretty big fire hose to drink through. As they say, "May you live in interesting times." We are.

What is your top management tip?

Hire the best people, support the hell out of them, try to inspire them, but don't micromanage them.

What would you single out as a career highlight?

I coined the term "hospitalist" 20 years ago, and it grew to be the fastest growing specialty in the history of modern medicine. Seeing this play out has been enormously gratifying.

If you had not chosen this career path what do you think you would have become?

I was a political science major in college (as well as being pre-med) and I suspect I would have been a policy analyst, a lawyer, or perhaps a journalist. I love to learn new things and trying to analyse and summarise them in a way that is accessible and moves the ball down the field. My last book, The Digital Doctor, was really a journalistic effort, which I enjoyed immensely.

What are your personal interests outside of work?

I am a passionate golfer, a decent piano player, and a religious New York Times reader (and a bit of a political junkie). My wife Katie Hafner writes for the Times, which is convenience — I get to not only read the paper but often help her with story ideas.

Your favourite quote?
Probably Avedis Donabedian, the father of quality measurement, who at the end of his life said, "The secret of quality is love.