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Ever tried to get sleep in a hospital? Ever wonder if anyone even taught them what care is? Some hospitals are great, but some sure aren't.

Managers of hospitals over the years have been increasingly recruited from outside the health service, and although their experience of running a supermarket chain might allow them to balance the books, it does not mean they have any insight into how a ward should be managed and patients best served.

In hospital, people should be able to have time to themselves.

I think the extreme complexity of medicine has become more than an individual clinician can handle. But not more than teams of clinicians can handle.

If, over time, patients don't go to some services, then progressively they become less viable, so you do arrive at a point where the conclusion is: 'These are the right services for the future, and this is capacity we don't need.'

People have been turned away from hospitals simply because they have no insurance. People have been put out of hospitals because they have reached the lifetime caps.

What we're really trying to do is level out the health care system. It has gotten so one-sided as more and more people have been put into managed care; in fact, about 70 percent of the patients in the country.

The vast majority of doctors really do try to take the money out of their minds. But to provide the best possible care requires using resources in a way that keeps you viable but improves the quality of care.

We are spending most of our time in American health care fixing the mistakes that either we in the profession are causing or our patients are, without recognizing it, causing to themselves.

I spent my 20s working in patient care at a large university hospital, an experience that has informed all my work and has given me a lot of human observation to draw on.