Intended for healthcare professionals

Observations BMJ Confidential

John Wennberg: Tenacious, optimistic, sceptical

BMJ 2014; 348 doi: (Published 08 January 2014) Cite this as: BMJ 2014;348:f7669

In the latest in its series asking the movers and shakers of the medical world about work, life, and less serious matters, the BMJ spoke to the creator of the Dartmouth Atlas of Health Care


John Wennberg is a US epidemiologist who first put unwarranted variation on the medical map. He showed what is now a commonplace but was then a surprise: that medical care varies greatly from place to place in cost, quality, and outcomes. Where you live determines how well, or badly, you are treated and how much it will cost: geography is destiny. He founded the Dartmouth Atlas of Health Care ( to document these variations, thereby helping to transform the understanding of medical practice in the United States. One solution, he says, is for patients to be far more involved in decisions about their care. Another is to limit …

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