Mea sententia

When I envision the ideal health care organization, I picture six characteristics.

A professional colleague and I were discussing (bemoaning) how hard it is to do quality primary care. She asked why I bothered to keep pushing for change in the face of so much institutional resistance and evidence that it was pointless. I told her, what we put up with is what we end up with.

In return, I asked her why she didn't push back and demand change if she is so unhappy about the way things are?  

Her response: "Well, I watch you, and I can see that it is pointless."

A professional colleague and I were discussing (bemoaning) how hard it is to do quality primary care. She asked why I bothered to keep pushing for change in the face of so much institutional resistance and evidence that it was pointless. I told her, what we put up with is what we end up with.

In return, I asked her why she didn't push back and demand change if she is so unhappy about the way things are?  

Her response:

"Well, I watch you, and I can see that it is pointless."

The wave of the future is bringing game-changing cultural shifts in patient awareness and expectations. These are paralleled (and fed) by paradigm changing technologies.  Clinicians and medical institutions will sink or swim depending on how well they ride these waves.

Those who choose the comfort of the familiar and predictable, who sit safely on the beach while they watch and wait, who allow others to build the future, these late adopters will ultimately be forced to enter the water. I predict they will never catch up, and will struggle merely to survive.

I found a wonderful article by Udkin, Dreger and Sousa, and have updated and adapted it. See below the fold…

I found a snippet in my Evernote file, sadly without anything citing a source. I have adapted it to fit my experience with Clinical Quality Improvement activities. I suspect it is broadly applicable…

Like most employees of large institutions, I am subject to a variety of ‘incentives’ that are designed to meet institutional needs, which may or may not be well aligned with my needs, to say nothing of the needs of my patients. 

Teaching in our local family practice residency is one of the most enjoyable parts of my week. When a colleague recently asked why I liked it so much, it took some reflection to answer.

Slow down, you move too fast.  It will all be over far too soon. 

I talked to a friend recently about a serious health experience. He had became ill suddenly and was hospitalized for six days. No one from his community came to visit. Only one person from work stopped by. No one called. He described being frightened by his illness and feeling vulnerable and alone in the hospital. He was devastated by what felt like abandonment in his time of crisis.

At a recent clinical staff meeting, a physician complained that the new requirement that clinicians enter all orders manually into the electronic record (CPOE) is slowing us down and causing errors. The IT and administrative staff were not the least sympathetic. Their message: it’s really not a big deal, it only takes an extra minute or two, and smart people like you should be able to master a simple skill like this.