The finding judges the case

A seasoned clinician can usually live with a review that finds they could have done something differently. What drives them away is how the review was…

Nov 2 • David Wild

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October 2026

The vial that wasn't there

Three ways to make a safety standard stick, and why the strongest one is the hardest to see

Oct 25 • David Wild

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The picture on the box

A mother's twenty-year search, a room of clinicians, and what happens when a leader holds the finished picture back

Oct 11 • David Wild

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“Effective immediately”

I was right about the process and careless about everything around it. Three leadership models explain why those are separate accounts.

Oct 4 • David Wild

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September 2026

Who can overrule the staffing decision?

A new bill would change who may own a physician practice. What a patient experiences depends on who governs it.

Sep 27 • David Wild

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The care got better. The number got worse.

A quality metric moves when the counting changes. Before you read it as a change in care, determine which one moved.

Sep 20 • David Wild

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The cost of the seat

The weight arrives after the decision is made. Somebody else pays for it.

Sep 13 • David Wild

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We've never asked that question

I have spent more weekend hours than I would like building a spreadsheet that should not have needed building.

Sep 6 • David Wild

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August 2026

I said it was nuanced

I opened with the case mix myself, before the surgeon had to. Longer cases, sicker patients, more transfusion. Every word of it was true, and none of it…

Aug 30 • David Wild

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No one is ready today

In the same meeting, working the same grid, the administrative seats had two or three names and the clinical seats had none.

Aug 23 • David Wild

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The caveat was true. The conclusion was not.

A trustee asked whether the pattern held in other patient populations. I had built the slide that said the question did not matter.

Aug 16 • David Wild

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The new out-of-network arbitration rule took effect. Almost none of it did.

The effective date was August 3. Three things landed. The provision written for anesthesiology got its date the same day, from a notice rather than the…

Aug 9 • David Wild

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