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Commentary
August 26, 2009

A Matter of Time

Author Affiliations

Author Affiliations: Institute for Healthcare Improvement, Cambridge (Drs Lloyd and Goldmann) and Department of Pediatrics, Harvard Medical School, and Departments of Immunology and Infectious Diseases, and Epidemiology, Harvard School of Public Health, Harvard University (Dr Goldmann), Boston, Massachusetts.

JAMA. 2009;302(8):894-895. doi:10.1001/jama.2009.1251

A novel “time eating” clock was recently unveiled at Corpus Christi College in Cambridge, England. Sitting atop this clock is Chronophage, a large grasshopper escapement that “eats up every minute of your life, and as soon as one's gone he's salivating for the next.” Health care time is certainly not protected from the voracious appetite of Chronophage, but the passage of time in any medical situation is perceived in different ways, depending on who is doing the watching. At many points in the delivery of health care, time seems to disappear altogether; in other situations, it moves slowly, lags a few beats, races ahead, or even lurches forward in a disconcertingly asynchronous manner. In this Commentary, a new perspective on time—improvement time—is discussed in the context of 3 traditional aspects of medical time: clinical research (knowledge) time, patient (illness) time, and clinical practice (disease) time.

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