by Tony Chen

I just got back from taking the CHE Certification exam and I'm glad to report that I passed (barely, I think!). Going into the exam, I was very unsure about my level of preparedness. This is really the first time I've gone into an exam with no idea how well or poorly I would do. Nor did I know what score I needed to pass - ACHE rightfully doesn't tell you what the "passing grade" is. All I knew is that 30% of takers fail.

Out of the 170 questions, I "marked" 65 questions that I was only 50% sure (I had ruled out 2 of the 4 answers). And it turns out that's about how many I missed - probably a bit more than half of those 65 + a few careless mistakes.

My two weakest areas were by far HR and law/regs. My two strongest - business and finance (fringe benefit of working at HFMA for those 3 years!). Anyway, enough about my test experience! For all of you still studying or thinking about taking the test, here's 2 things I would've done differently:

(1) Paid more attention to terms / concepts in my everyday reading. If I had just quickly took the 2 minutes to understand terms, concepts, and acrynoms that I encountered while reading ModernHealthcare, news stories, or Healthcare Executive, over time... my general healthcare knowledge would've broadened significantly.

(2) I should've taken Nick Jacobs' advice - sit down and have lunch with individual functional leaders in procurement, legal, operations, nursing, medical staffing, and HR and just ask them lots of questions. This would've raised questions that I should've been asking and given me a good start at new relationships within my organization.

Anyway, I will enjoy the rest of the year as a CHE and wonder if I will be the shortest-standing CHE in ACHE history - 3 days (from everything I can tell, I'll convert over to FACHE per the new policy on 1/1/2007). More importantly, now that I'm done studying for any more tests, more time for blogging!

Have a happy and safe new year! In the meantime, go check Hospital Impact Blogger (and also newly CHE'ed) Andrew Barna's new website Healthcare Tomorrow.

by Tony Chen

so I've been having major blogger's block recently. Mostly, it's due to the fact that I've been trying to study for my FACHE exam (coming up on 12/28). Everyone told me to read "The Well-Managed Healthcare Organization" as the go-to source, but I've been finding it difficult to digest. Have you ever read something two or three times, arrived at the end of the chapter, and realized you didn't learn one single thing? I feel that way a lot with this book. And it's not because I already know it - somehow I just don't know what to retain.

It really hit me the other day that I work in a hospital. I heard a sentence that had just as many acronyms as actual words...

"Should we use CBT, ICD-9, CDM, or DRG?"

Loaded question - anyone know the answer?

It's been a while since I updated ya'll on all the hospital administration blogs that are out there. Even though we are few and far between, we've grown by leaps and bounds in the last few months. Doctor blogs, nurse blogs, patient blogs, and healthcare policy wonk blogs are all fairly well documented, but not hospital administration. So, here are the folks blogging from the front lines of hospital leadership.

Of course, I have to start with the three other bloggers at here hospital impact.

- Nick Jacobs at WinberBlog - Nick is the first hospital CEO to start a blog - he's an unconventional CEO that has unconventional wisdom and insights.

- Andrew Barna at HealthcareTomorrow - Andrew is Director, Special Projects at Stanford Medical Center and has pithy, concise analysis on healthcare trends he sees.

- Craig Ahrens at The Business of Healthcare - Craig is Manager at ECG Management Consulting and does quite a bit of service line improvement work. His first-of-its-kind "healthcare talkshow" lets us hear things straight from the horse's mouth.

- Paul Levy at Running a Hospital - Paul is President/CEO of Beth Israel Deaconess Medical Center in Boston. He's a relatively late-comer (just started in August 2006), but has already developed quite a following, from everyday Bostonians to national policy wonks. Arguably the hospital administrator blog getting the most attention.

- Christina Thielst at Christina's Considerations - she's a HCA hospital COO. Back from healthcare consulting with a vengeance! Lots of good focus on RHIOs and HIT.

- Dr. William Roper at "Roper on Health" - Dr. Roper is CEO of UNC Health System - for some reason, the blog hasn't really caught too much attention. In part, it's because Roper rarely offers opinions and other posts sometimes seem more like UNC PR.

- Joe at Joe Oncology - Joe heads up two cancer centers in the Southeast and wonders how to balance compassionate care and hard-nosed budgeting.

Happy thanksgiving everyone!

I've noticed that I always gain 5-10 pounds around this time. And what's worse is that my eating habits that I start for the holidays are also hard to break. For tips on how to avoid the thanksgiving-to-christmas weight gain, check out these tips from WebMD. Whip out those tight-fitting pants and/or belt!

Thanks to all those healthcare workers who worked during thanksgiving, and for those who pulled out all the stops for patients who found themselves in the hospital.

by Tony Chen

So, I've been going through sort of a dry spell in terms of blogging. It's probably due to a combination of increasing work demands, studying hard for the CHE certification, taking care of the newborn, and local church board responsibilities.

When I do find a quiet moment, I find it ironic that we live in a culture that celebrates workaholicism. Putting in the hours is a badge of honor. If you see hospital execs that work 80-hour-work weeks, shouldn't we look at that the same way we look at doctors who smoke? Nonetheless, we always hear about those crazy success stories of great people who forgot to sleep or eat. We hear that anyone who's ever achieved anything great had to work HARD for it. How many people did great things working 9am-5pm?

I guess I'm starting to realize that it all depends on my definition of great. I could spend my every waking moment trying to make my health system the world's most innovative, forward-thinking, business-savvy health system in the world. 15-20 years from now, maybe people would mention ENH in the same breathe as Google, Apple, and P&G.

Or, I could continue to do what I do, and do it passionately, but leave it all behind at 5:30PM and enjoy my son's first green drool, first belly laugh, and spend time laughing and chatting with my wife. Maybe I'm getting soft.

Another part of me also thinks that this stage of my career (age 30-40) is really where the trajectory can pick up quickly. If I make "small" smart moves now and just "put in my time" now, it will pay off handsomely in the long run - maybe retiring much earlier or traveling much more or ...

I guess in my newborn-induced semi-coma, forgive me for getting a little pensive and thinking about what really lasts in this life. What are you willing to give your life for?

by Tony Chen

I'm sure we've all grown to enjoy reading Nick Jacob's unconventional wisdom about hospital management and being a hospital CEO. Always the trendsetter, Nick started the first hospital CEO blog ever.

Now, he's got some company. Check out Paul Levy's blog - he's the president and CEO of Beth Israel Deaconess Medical Center in Boston (yes, it's THAT Beth Israel, the one with 530 beds). What I found really interesting about his background is that he's pretty much never done anything related with healthcare or hospitals before. So like Nick, I'm sure he'll have some much-needed perspectives and insights.

and while we're at it - here's another new blog started by a hospital team on patient safety and patient-centered care. Check out their post on JCAHO imposters - make sure you check their IDs!

Some of you may have seen that our blog was down today. Apparently some hackers found an "open access" folder in one of my directories and sent 1,000s of fradulent citibank emails with some kind of insecure script.

Once my hosting company found the problem, they had to bring the site down. In fact, they were close to deleting everything! I caught them in the 11th hour and we identified the folder with the script and deleted it. Unfortunately, that folder contained all the photos I've used for the site for the last 18 months. Nonetheless, we are back in business!

Anyway, thanks for your patience and for reading!

ps - I'm still working on a few other technical problems with the RSS feed. Us non-technie new fathers are pretty slow and need help with that kind of stuff...

thanks to Dr. Nick Genes for the great interview (free reg req) that was on Medscape's business of healthcare frontpage all of last week. Looks like we got ~2000 visitors from that article. And my post of "If Disney Ran Your Hospital" that I put up last year hadn't received any comments now has a pretty nice thread.

Yes, it's that time again when Grand Rounds will be here again at hospital impact. Check out this week's edition at Mexican Medical Student.

I'll be accepting just about any kind of medical/healthcare-related submission, but I'm be somewhat partial to any posts that would be good for healthcare newbies.

Email me at tony[at]hospitalimpact[dot]org with "Grand Rounds" as the subject line. Early submissions are definitely welcome! At the very latest, get them to me by Monday, 8/14, 5PM EST.

The last time I hosted grand rounds, it was in the form of a letter from a janitor to a hospital CEO. We'll see what we can whip up this time.

8/11 12PM Update: so far, I've received 18 submissions, keep 'em coming!

8/14 10AM Update: we're up to 52 submissions, now I'm expecting the wave of last-minute procrasinators like me...

A talk show and discussion forum dedicated to the strategic issues impacting the business of healthcare

I'm pleased to announce that Craig Ahrens will be joining the Hospital Impact blogging team. I "met" Craig via the growing healthcare blogosphere. If you haven't already, check out his semi-weekly healthcare "talkshow" podcast through either:

If you have Itunes on your computer, click here
If you don't have Itunes, go straight to "The Business of Healthcare" blog

The following is a listing of the type of healthcare topics Craig covers with guests and that he will blog about at hospital impact. The guests range from hospital executives to healthcare consultants:

Show 6: Service Line Success and the Strategic Impact of the Rebasing of DRGs
Guest: Preston Gee is a senior managing director with Phase 2 Consulting in Austin, TX. Gee is a noted author and health industry thought leader on the subject of market-driven strategies for hospitals and health systems. His most recent book, Service Line Success: Eight Essential Rules, represents the author's eighth professional book and can be purchased at the Health Administration Press at ACHE's website.

Show 5: Orthopedic Service Line Planning
Show 4: Neurosciences Planning for Healthcare Institutions
Show 3: Human Resources as the Critical Hospital Strategic Partner?
Show 2: Patient Satisfaction and Customer Service as a Hospital's Strategic Priority
Show 1: Surviving and Thriving as an Independent Hospital in a Competitive Market

Craig is a healthcare strategy consultant whose professional experience includes general hospital strategic planning processes, operational turn-arounds, physician business development, and service line planning. Craig's past professional experience includes working for the Tiber Group in Chicago, BJC Healthcare System in St. Louis, and other large providers within the Midwest.

Please welcome me in joining Craig to the Hospital Impact. His posts will focus on adding color commentary and generating discussion around the podcasts that he produces. You can reach Craig at info@thebusinessofhealthcare.com.

I'm off to Seattle tonight for a week for my sister-in-law's wedding. Our hotel room has internet access, but I've decided not to bring the old laptop - we figure that traveling with a 6-week old will be enough excitement to keep us buzzing. maybe I should start a new father blog...

See ya'll next week...

By now, I think we are all familiar with Grand Rounds - the carnival of the best of the medical blogosphere.

Recently, a few other carnivals have spawned from big pappa Grand Rounds:
- Change of Shift - as you could guess, it's a nurse-focused carnival (just had their 2nd edition)
- Health Wonk Review - the best of healthcare policy wonks, economists, leaders, and businessfolk (just released their 11th edition)
- Patient-Consumer - the best (and worst) of patient stories. (just released their 2nd edition)

Amazing, isn't it? At this very moment, we can surf the blogosphere to find the best blogging perspectives from doctors, nurses, policywonks, and patients. What's next? There seems to be two more major gaps: Healthcare IT and hospital leaders.

Speaking of hospital leaders, I wanted to draw your attention to another hospital leader blog, Lotus Health, by J. Dinger, the VP of Srategic Advancement for a 5-hospital system in TN. Welcome JD to the healthcare blogosphere!

Now that I am really working in the hospital setting, I have to admit - I have been thinking more about what this blog should be about.

I'm definitely not one of those bloggers that lays it all out there for everyone to see. But I also think that authenticity, rawness, and political incorrectness is exactly what makes blogging valuable. Add on top of that the fact that my role includes taking advantage of market trends and thinking competitively, especially in the Chicagoland market.

So, I want to continue to share my musings about healthcare trends and think more deeply about how hospitals should respond. Are we entering into a new era where the very nature of hospitals will be changing? Will it be good enough to simply provide world class "healthcare services?" Yet, for competitive and common sense reasons, my hospital role will force me to apply a filter for my blogging.

Since Timothy has been born almost two weeks ago, the break from blogging has definitely refreshed me. Although I love being immersed in healthcare news every day, I've noticed that these past two weeks has given me a chance to step back a little bit. Amazing how quickly some "news" just fades away into triviality and how truly important and strategic things can be hidden from day-to-day perspective. I'm still looking for that balance of info intake & info digestion.

I'm also looking for that balance of how to juggle a new job, a new child, a new townhome, community/church responsibilities, and blogging. Though I'm not sure what it'll look like yet, Hospital Impact will have to evolve. Geesh, props to all those who've been blogging for so long!

After a short delay, I finally got to attend new employee orientation at Evanston Northwestern Healthcare. In many ways, the day went exactly like I thought it would:
- Out of 60 new employees, ~50 of them were nurses, many of whom were fresh graduates. I was one of 5 guys there.
- No other new employees were from administration
- We talked about good hand hygiene
- We talked about values
- We got a $4 lunch voucher
- I was overwhelmed with all the benefits information

What I didn't expect (and was pleasantly surprised with):
- Mark Neaman, ENH's CEO/President made a personal appearance to welcome us and pump us up a little.
- We had a great presentation from the performance improvement department. They challenged us to look at our jobs & our organization with our precious "newbie" eyes and to take the initiative to provide feedback.
- The session was designed for some good interaction amongst us new employees - a few games, contests, etc. I didn't think they would bother as almost none of us will be working together. But you never know.

Now it's time again to select medical/ dental/ pharma/ vision/ 403b/ insurance plans.

Well, this was supposed to be my first week working at Evanston Northwestern Healthcare as their new Director, Business Development. On Sunday night, I was getting all ready to attend their new employee orientation on Monday morning.

The only problem was that this little guy had other plans.

Monday morning around 2:30AM the bag of water was officially "unzipped," preventing me from going to work. Instead, I traded my hospital administrator role in to be a patient. Timothy Chen was born June 12, 2006 at 11:45PM. Our first child. 6 lbs.

And given that my wife is an OB-GYN, it was extra special/funny/weird/great to be an OB patient. Just imagine your boss delivering your baby, only that it's completely no big deal.

I'll be taking some time to get used to my new role - both at home and at work. I'll continue to blog, but probably a bit less. Any and all parenting advice is welcome!

I had to skip out on my 1st day of work at the hospital today... nonetheless, I am in the hospital playing the role of a happy patient's spouse today! more later...

Well, this will be my last week at HFMA. I'll work through Wednesday, have Thursday and Friday to take a short breather. Then, on Monday, I'll be at Evanston Hospital for new employee orientation.

Out of 10-12 bosses I've had in my career, I think the best two I've had were here at HFMA. Picture the best boss you ever had - how would you describe them? I'd be willing to bet that they were both nurturing AND demanding.

And speaking of nurturing and demanding, I also don't think I've ever worked in a place with a better working environment - high importance on both relationships and results. It probably doesn't sound like a big deal, but I think a great culture is one of those elusive benefits that I will only appreciate more and more as time passes.

Anyway, blogging at hospital impact will probably be light this week as there is still quite a lot to do to wrap things up well. I'll also be preparing to speak at the PCMA Chicago Chapter meeting on Business Analysis.

Check it out at The Medical Blog Network.

also, check out the interesting comments on my "best" hospitals post.

I've always wanted to work in a hospital. Now I am getting my chance. Starting June 12, I will be working at Evanston Northwestern Healthcare as their new Director of Business Development. In this role, I'll be finding great ideas to enhance/expand the health system's services, evaluate them from a business perspective, and then implement them into reality.

I'm asking all of you healthcare folks out there who read and blog - what advice would you have for me as a mid-level person working in a hospital for the first time? I've already received some advice from some friends and fellow bloggers - take the time to build trust and credibility with physicians; get to know the clinical areas more than you think you'll need; shadow a doc or nurse once a quarter; understand that difference of opinions is sometimes because difference of incentive.

But what would you say? What advice would you give a family member or friend who was going into hospital management as a newbie?

Specifically:
- What are some best practices or pitfalls in working with physicians and other clinical staff?
- How do I make constructive changes in a constructive way?
- Are there any "Sacred cows" in hospitals that can not be touched or talked about?
- What type of person stays the long haul in hospital management, enjoying it every step of the way?
- What do you *really* think of hospital management folks?

a little help, please!?

UPDATE: make sure you check out this hilarious/disturbing bit of "advice" I received from someone.

Medpundit (aka Dr. Sydney Smith) has bid farewell to her blog. 500,000 visits in, she realized that she couldn't keep up with the frequency and quality while taking on additional work responsibilities and spending more time with family. Go back to her first post way back in March 2002 here on the problems Europeans were finding with herbal medicines.

Medpundit is considered the matriarch of the healthcare blogosphere. 4+ years of blogging, a few posts per week - tha's probably close to 1,000 posts. What dedication. What insight. Even though I've never met her, I feel like one of my most respected and beloved neighbors is moving away. Syd, we will miss you.

I think just about every healthcare blogger feels a loss today, but we are also happy for her. Also, if we're honest, at least for a second, we considered whether we should call it a bloggin-day as well. For me, the last 15 months of blogging has felt like a lifetime (in a good way). And yet, we know that we haven't even scratched the surface of the many things we could blog about.

New baby on the way. Moved from the city to the suburbs. Starting a new job in 3 weeks. and now Medpundit signing off the blogosphere. This is just too much!

Check out this week's grand rounds for more thoughts on Medpundit's last post as well as the good-bye party.

well, it's been quite a few days for me recently. Last week, we closed on a new townhome, we moved in, and I accepted an a job offer to go into the provider setting. All the while, I've been trying not to overstrain my 8-month-pregnant wife.

Next month, I'll be joining Evanston Northwestern Healthcare as their new Director, Business Development. Essentially, I'll be looking for the best new ideas to grow the hospital's services, analyzing them from a business perspective, and implementing them into reality. More on this later, but in the meantime, the blogging here at hospital impact will keep going but probably at a slower pace. New baby on the way, new home, and new job - I guess I'll have to practice what I preach in regards to change management.

Also, this would be a good time to say that we are still looking for one more guest blogger.

Exactly one year ago, I was yelling at my computer, wondering if this darn blogging software was ever going to work and asking myself what I had gotten myself into. Now, 320 posts later, we've reached our first birthday! It's really hard to believe that it's only been a year.

Some highlights from the year:
- Top 5 weirdest search terms that landed someone on this blog: Mother of all matter, brother&sister, accordian lessons alabama mobile, bed movies, i am a janitor
- Most unrelated site that links to hospitalimpact: www.samanthaburns.com (though I think she recently deleted the link)
- Most popular posts: Grand Rounds 2.05 (in the form of a letter from a hospital janitor) and the "If Disney Ran Your Hospital" Series
- Worst posts: when I mistakenly praised yahoo finance and shafted FDR.
- Best thing I did on the blog this year: had Andrew Barna and Nick Jacobs to blog with me.

For all those readers who've been with me from the start, thank you! What was the highlight for you? What would you like to see more of this coming year?

Let me leave you my two favorite non-healthcare blogs: waiterrants (our hospital registration staff should be trained by this guy) and Postsecret (safe way to vent. I wonder if this would be HIPAA-complaint)

Looking forward to another great year.

Not only am I looking for a good guest blogger, I'm also open to guest posts! If you'd like to submit a post to appear at Hospital Impact, here are my submission guidelines:
- The topic can be focused on any aspect of hospital administration/leadership. Drawing from other learnings from industries is highly encouraged. Issues that tie back to the hospital impact tagline above are also especially welcomed.
- Keep them relatively short (250 words or less), as blog readers are scanners or are busy or both.
- Send it either as a .txt file or .rft file (this way I can cut and paste pretty easily).
- Let me know if I should use a pseudonym; otherwise I'll use your real name. I would also be happy to link to your website/blog.
- I'll still reserve the right not to use it or to edit as I will maintain overall editorial control; but for most good pieces, I probably won't edit them at all.

Got an insight for hospital leaders? Please share with us!

Do you have a passion for great hospitals?
Do you have a way with words?
Are you currently a hospital leader?

We are looking for a Guest Blogger to join the team of me, Nick, and Andrew and to post inspiring, insightful, informative posts approximately once a week. If you are interested, please email me (tonyAThospitalimpactDOTorg) the following:
- your name
- your organization
- your role
- why you would like to blog for hospital impact?
- a sample post (250 words or less) (note: unless you notify me otherwise, I may use these posts and give you the appropriate credit)

Why become a guest blogger?
- Become a valuable resource for your colleagues in the industry
- Become known as a healthcare blogger
- Interact with other progressive healthcare thinkers and leaders
- Notoreity/Recognition (your choice)

Why am I looking for a guest blogger?
As Hospital Impact continues to grow (check out our SiteMeter ), I'm realizing the need for an injection of some fresh perspective. Andrew and Nick both do a great job thinking of things that I would never ever think of, and their posts expand my worldview. So, I think it's time to add yet another fresh perspective. I'd be particularly keen in adding someone who currently works at a hospital.

Additionally, my role in my day job continues to expand and grow, just as my role in the evening (update: our 1st child was born June 12, 2006!) continues to expand as well. (Studies show that for men between the ages of 30 and 40, our level of responsibility increases 25% every year). So, realistically, I probably can't keep up and I need some help! Nonetheless, I still plan to blog regularly.

Why not just start your own blog?
I would encourage you to do that as well! There is a small but growing community of hospital leadership blogs (we can almost form an ACHE member blogring). Nonetheless, my only advice is to be realistic about the time commitment - you'll want to post as often as you desire people to visit. And even for a seasoned blogger, it'll take 30-45 minutes for a thoughtful post. If inspiration hits you once a week or less, maybe joining as a Hospital Impact blogger is the better option. Nonetheless, you may be perfectly content in posting once a week (Andrew posts every Monday on his blog HealthcareTomorrow and then every Wednesday here at Hospital Impact)

I have been pleasantly surprised at the consistency and quality of a new (at least new to me) hospital administration and leadership blog: check out Christina's Considerations. I think her blog will grow in importance as RHIOs come to the forefront. I asked her a few questions via email and she was kind enough to offer up her responses.

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Why did you decide to start a blog about healthcare leadership issues?

I had a few reasons for starting my blog after hearing one of the top bloggers in the world (Doc Searls) speak here in Santa Barbara. First, healthcare leadership is what I know and my professional passion. Second, I wanted a vehicle to help educate administrators on topics such as HIT, RHIO/RHINs, Workplace Effectiveness and Healthy Children. I have something to say on these topics, but it doesn't always fit in with the established media's editorial calendar. Lastly, and personally, it is a great tool to help me keep reference information organized!

Why are you particularly interested in RHIOs?

I heard about the Santa Barbara County Care Data Exchange (SBCCDE) when it was first getting started and met Lori Evans. From the first day, I could not wait until my personal health information could be electronically exchanged between my healthcare providers. Then Dr. Brailer contacted me an asked me to help move the SBCCDE from a loose collaboration to a nonprofit corporation. The term RHIOs was later defined when he became the National Health Information Technology Coordinator, and to me refers to those collaboratives with formal organizational structures and systems for authority and accountability. I enjoy building effective healthcare organizations and RHIOs are the new frontier!

I also want to make contributions which will ensure the safety, security, privacy and confidentiality of my private health information.

What are the top 2 or 3 things all hospital CEOs should know about RHIOs?

1. RHIOs are a vehicle for delivering interoperable health information exchange and building the National Health Information Infrastructure.
2. Administrators have a responsibility to their community to participate in developing collaboratives and networks in their area.
3. As the largest organization in most communities, hospitals are at the center of health related activity and in a key position to help drive interoperable health information exchange for improved safety, quality, access and efficiency.

What will it take for our hospitals to be the best run organizations on the face of the planet?

Strong leadership and effective workplaces!
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Also check out a few of my recent favorite postings on the 5 things consumers need to know about personal health records and what healthcare execs need to know about P4P. Thanks Christina! and Happy blogging!

If there are any other hospital administrators and/or ACHE members out there blogging, let me know, we should form a mini-blogosphere.

well, the votes are in.

Unfortunately, we fell 8 votes shy of what would have been an astounding upset of the Bioethics Weblog - by far, this was the closest race of them all. Even though our readership is probably 10x smaller than theirs, we put on a race to remember. They mounted a surprise and smart vote drive in the 11th hour, almost doubling their vote count in the last 24 hours.

Thanks to all who voted for Hospital Impact - I really do appreciate it. And to the bloggers at the Bioethics Blog - congrats and great blog.

And now back to our regularly scheduled program.

The new year is upon us and with it, voting for the 2005 Best of the Medical Blogosphere competition at Medgadget has begun.

If you like what you see here at hospital impact, and if you like rooting for the underdog, vote for hospital impact in two categories:
- Best Health Policies Blog
- Best New Medical Blog (created in 2005)

(click on both links to vote in both categories)

UPDATE: You can also view real-time results for:
- Best New Medical Blog
- Best Health Policies Blog

All the underdogs there ever were are counting on you!

Like I posted previously, given the niche of hospital leadership topics that this blog is deliberately focused on, the odds are against us. Nonetheless, it's an honor to be nominated and regardless of who wins, it's a win for us all: the medical blogosphere continues to grow in quality and quantity.

However, this begs a question. At the risk of sounding disloyal to my fellow medical bloggers, is the non-medical healthcare blogosphere big enough to sustain its own annual awards and "grand rounds"-like carnival? Or should we continue to piggy-back off of the medical blogosphere?

I love the way the current grand rounds is going - it's a great mix of medical stories, scientific developments, IT issues, and industry commentary. While the readers are predominantly clinical folks, there are a spattering of others. But I'll be honest - as a non-medical person, there's only so many pictures of punctured lungs, there's only so many stories of patient/physician relationships that I can read before I realize I might be a little out of place. Don't get me wrong - I have mucho respect for my medical colleagues - what they do is nothing short of amazing. But is it time to segment the medical blogosphere into medical and non-medical topics in order to gain more in-depth focus? Or is the richness really in the wide range of topics reaching a wide range of audiences?