My blog represents my personal experiences and perspectives. This includes many anecdotes from my life and from my medical practice. I have been scrupulous to anonymize all medical anecdotes and to avoid ever belittling or making fun of patients. (I often make fun of and criticize myself, my colleagues, and the institutions where I have worked.)
Our job – though many of us actually see it more as a calling than a job – is to care for patients.
Niels Bohr said: “There is no quantum world. There is only an abstract quantum physical description. It is wrong to think that the task of physics is to find out what nature is. Physics concerns what we can say about nature…”
I think this parallels the enduring human drive to search for Truth. There may or may not be an absolute Truth, but it is wrong to think we can discover Truth or understand what Truth is. Science, philosophy and religion are merely our endeavors to see what we can say about Truth.
I am both excited and worried about the recent enthusiasm for precision medicine (PM)
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.