Bibliographical noteFunding Information:
Dr. Mark Linzer, a primary care physician at Hennepin County Medical Center in Minneapolis (just a few miles from where I work at the University of Minnesota), was more perceptive. With funding from the Agency for Healthcare Research and Quality, he initiated the Physician Worklife Study in 1996. He found that relationships with patients were how primary care physicians derived satisfaction and sustained themselves. He predicted that a failure to align physicians and health-care executives around common values (including patient-centeredness, purpose, and compensation philosophy) would hurt physicians and lead to “burnout.”2,3 Then, in 2000, the Institute of Medicine (IOM) published To Err Is Human: Building a Safer Health System4. The claim that preventable errors caused up to 98,000 deaths each year in hospitals in the U.S. shook the medical world. Physicians realized that our outcomes were not as good as we had believed, that most of our failures were due to system errors, and that we needed better methods and tools to reliably deliver safe, high-quality care. Over the ensuing decade, quality and safety did improve.