At the end of day two, one of the most striking realizations (and perhaps most uncomfortable) was how protected physicians are within a system that often fails to protect the most important stakeholder in healthcare: the patient. The Michael Skolnik story, simply put, was a case of a physician who exercised poor judgment and of a patient and family who were not made aware of the alternative courses of action they could take in a complex situation. More tragically, this is a case of a physician who exercised poor judgment in a system that allowed him to do so. One’s natural impulse is to feel anger towards the physician, who seemingly nearly coerced a vulnerable patient into a likely unnecessary procedure. While that anger may rightfully be directed toward that physician (personal accountability and responsibility should absolutely be at the forefront of such a case), investing one’s energy solely into… Continue reading
In medical school, standardized attempts at teaching us how to communicate are made but I’ve always been left to wonder how effective such measures are. Can we really teach someone how to listen? How to feel in response to a patient’s words? How to react in such a way that compassion and empathy are assumed rather than indifference? Medicine attracts individuals who inherently have a predisposition to help and to care. Nobody enters into this profession with the intent of cold indifference. However, many do leave this profession desensitized to the pain, suffering, and grief that they encounter multiple times per day. And perhaps it is this latter point that leads to the devolution of perceived empathy.
Of all the lessons learned in this immersive experience at the Telluride conference, it is the lesson that communication, or the lack thereof, is at the center of most errors and patient dissatisfaction… Continue reading
Having spent the past year as a chief resident in quality improvement and patient safety, I’ve come to the conclusion that QI is at most times frustrating, at many times defeating, and, in sweet but rare moments, enriching. This has been my (limited) experience, at least. Working inside an institution that has been under intense scrutiny for its quality and safety issues, rarely a day passes in which I’m not pulled into a discussion about a recent safety event, near miss, or upcoming meeting with hospital leadership regarding a root cause analysis. Perhaps my sense of disappointment stems from the fact that meaningful, systemic solutions to the problems our institution faces are almost invariably faced with inertia and a lack of buy-in from involved parties.
I maintain hope for the future of quality and safety because it is still a relatively new phenomenon, at least in the field of healthcare.… Continue reading