My blog represents my personal experiences and perspectives. This includes many anecdotes from my medical practice. I have been scrupulous to anonymize these 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.)
Dr. David Nash makes some very good points about the importance of recognizing both the relevance and the lack of alignment with physician beliefs of patient preferences, commenting on a December 4, 2011 JAMA commentary by Dr. Allen Detsky.
“…it’s easier to add stuff than to take it away. It brings to mind thesecond law of thermodynamics in physics, which (very loosely) says that a system will always develop greater disorder (or randomness, or “entropy”) unless work is done on that system. Stated from a clinical point of view: unless we invest more time and energy in our patients, their care will become more scattered, disorganized, and chaotic.”
"Vision is not enough. It must be combined with venture. It is not enough to stare up the steps. We must step up the stairs."
(Vaclav Havel)
During an interview in the post season, the franchise quarterback explained his success.
Our institution has recently started using NRC PIcker to collect patient feedback and grade clinical providers. When I learned of this, I was anxious, defensive, offended and prepared to be angry at the prospect of being graded by data from some feedback form. I suspect my reaction is pretty common among providers. My discovery that the data includes some very useful material - and that I score well - has been a surprise, somewhat confusing, and led me to do some self-observation while with patients.
All mushrooms are edible, but some only once. (Serbian proverb.)
For all my friends and colleagues at CMHC (with deepest apologies to Lerner and Lowe)…
All I want is a place somewhere,
Not locked down by Committee Chairs,
Where all who want can go to share,
Now wouldn't that be loverly?
Lots of documents for us to read.
Lots of communication, indeed.
Where creativity can breed.
Oh, wouldn't it be loverly?
Oh, so loverly as we all collaborate at will
We would never need to budge
For stuff that thrills like a sleeping pill.
Sir William Osler famously said: “Listen to the patient. He is trying to tell you what ails him.”
The German philosopher Hegel said, “We learn from history that we don’t learn from history.”
The process of becoming a physician is a long and gradual process. Scattered through this glacially slow and often painful process are episodes that are transformational in every sense of the word, experiences that impact what kind of physician one becomes. Or even, whether or not one becomes a physician.