Nursing and the Trojan horse for quackery

Detail from The Procession of the Trojan Horse...
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I watched Dr. Donald Berwick‘s keynote speech at yesterday’s National Summit on Advancing Health Through Nursing (webcast available at Dr. Berwick, of course, is a pediatrician, a leader in quality-improvement efforts in health care, and since July the head of the Center for Medicare and Medicaid Services (an Obama recess appointment–Republicans in Congress vowed to block Berwick’s appointment).

First a few random observations from watching the live webcast: 1) power-suits for women plus bright scarves seem alive and well for the nursing leaders there, 2) it is never a good idea to get filmed texting when you are an audience member at a national event like this…

A disclosure is that I have been a big fan of Berwick’s ever since he gave a (similar) keynote speech about ten years ago at a pediatric quality improvement conference I attended in San Diego. It wasn’t just the sun in San Diego that made me like him. I have a well-used copy of his 2002 Commonwealth Fund Report “Escape Fire: Lesson for the Future of Health Care.” My copy is dog-eared, tagged, and highlighted in many places. I use his writing for my health policy courses, but also as a practice morale-booster when I am doing head-banging (see previous post) in frustrating primary care. To paraphrase him from “Escape Fire” he says that we must face the reality that our US health care system is not working–that tinkering with it will not make it work–that we need a new system–and that we need to have the courage to address these problems head on “..without either marginalizing the truth-teller or demoralizing the good people working in these bad systems.”

Kimball Atwood IV, MD is an physician-editor with the blog “Science-based Medicine” ( He says he became interested in pseudoscience after he attended a nursing conference at his own hospital where they discussed therapeutic touch. (I have a healthy dose of skepticism on therapeutic touch as well).  In a recent blog post “New CMS Chief Donald Berwick: A Trojan Horse for Quackery?” Dr. Atwood expresses his dislike of Dr. Berwick–mainly because Dr. Berwick is a self-proclaimed “Patient-centeredness extremist.” But Atwood also claims that Dr. Berwick is a Trojan horse for quackery now at the federal level, based on the fact that Berwick shared the podium with Dean Ornish and Senator Tom Harkin at the IOM Summit on Integrative Medicine.”  So, does the fact that Berwick was the keynote speaker for the IOM nursing summit–and that he even spoke of “the majesty of nursing” (really a Hallmark moment I could have done without)–mean that he is a Trojan horse for quackery and nursing is part of that quackery?

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