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.)
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.
Did you know that there is a whole branch of psychology devoted to the impact of interruptions and distractions on learning, memory, performance, productivity, and decision making?
It’s frustrating when they won’t let you be a playwright, but then complain when you become a critic.
Lisl was very good high school skier but seemed not to have the race results she was capable of and everyone expected.
In practice, it was clear she had great technique and a good motor, and could stay at the front without difficulty. In races, however, she would set out looking fantastic but come in near the end of the pack, beaten by skiers with much less ability than she, and seemed happy with her race. It never seemed to bother her. In fact, she never complained and was always one of the happiest in the van on the way home.b
A physician friend commented recently that he was being ‘meeting-ed to death’ and wondered if it was intentional. It turns out, he was on to something.
Chart review is one of my occasional clinical responsibilities. The charts I see overwhelmingly document good quality medical care. Last week I saw a chart that gave me pause.