Mea sententia

The leadership and management techniques that still dominate in the early 21st Century remind me of the mediocre and aging rock bands so common in local and regional venues: neither group has realized they are past their prime. Change is inevitable. Success is not. Mark Twain wrote that sacred cows make the best hamburger. We shouldn’t be adding spices to stale recipes or spoiled food. We should be designing a new menu.

Several recent events make this a good time for me to start posting intermittently on what I see as the collaborative approach to patient care.

“The name of the game in this economy and this health care climate and this political world is exclusion. You know it and I know it. We just don’t want to talk about it.”

First they ignore you.

Then they laugh at you.

Then they fight you.

Then you win.

(Gandhi)

Good questions can give good answers.

At recent meetings, senior leadership and management have spoken eloquently and forcefully about the huge challenges we in health care face from the perfect storm combination of an ongoing national financial crisis, the health care reform act with its unknown and largely unknowable changes, and our local revenue shortfalls. They emphasize the need for innovations that are carefully considered, centrally controlled, and rapidly developed and deployed. The theme is: “Major change is inevitable, and mistakes are not an option. We have to get it right the first time.” 

I will never forget the quasi-humorous sign in the radiology reading room:

I’ll see it when I believe it.

Robert Burton, a former Chief of Neurology at Mount Zion Medical Center, explains it this way:

The trend of the last two decades toward patient-centered (or family-centered) medicine is unmistakable and and a very good thing. Unfortunately, it is often discussed in the abstract, which obscured the fact that no two patients are identical in their needs or desires. Kevin Pho’s recent discussion gets it right: 

Whereas, on or about the night prior to Christmas, there did occur at a certain
 improved piece of real property (hereinafter "the House") a general lack of
 stirring by all creatures therein, including, but not limited to a mouse.

It could have been a big deal, but it wasn’t. Our appointment to discuss our options for diagnosing and treating a potential malignancy had been scheduled with the wrong interventional radiologist.