One of today’s core ideas was the vital importance of shared decision making in a safe and patient-centered health system. So many considerations enter into the process of shared decision making – the involvement of friends and family, patient advocates, or health proxies; the inclusion of a multidisciplinary care team in the conversation; making time and space for patients to come to decisions without feeling unduly rushed or pressured. Our conversations on the subject brought to mind an experience I had as a patient in the healthcare setting a few years ago.

I’d gone to see a physician for a problem that I understood only poorly, for which I had attempted self-care unsuccessfully at home. When the problem failed to resolve itself, I knew the wise thing to do would be to involve a health professional. Her recommendation was that I seek an appointment with a surgeon, a prospect that… Continue reading →

Yesterday, we were privileged to have the opportunity for quiet reflection at our nation’s Arlington National Cemetery. While there, David Meyer challenged us with a staggering thought: there are roughly 400,000 people buried in Arlington over the course of the last 150 years. However, every single year the Institute of Medicine estimates that 400,000 people are killed as the result of a medical error. This means that every single year, our failures as a healthcare system fills Arlington National Cemetery’s plots all over again.

That anyone could fail to act in the face of such astonishing carnage is ethically unthinkable. I have already learned so much this week about what we can do to impact these statistics. I hope that, when this week has ended, I’ll be able to do my part as an agent of change.

For those who are aware of the risks inherent in our current system of medical practice, there is a dangerous cognitive trap – a trap that catches many good caregivers who otherwise have only the best intentions and the utmost concern for their patients. That trap is the trap of exceptionalism.

“I understand that central line placement is invasive and leads to many infections in the healthcare setting each year, but none of the central lines that *I* place get infected.”
Or, even more dangerously: “I don’t have a study to support this decision, but *every* time I’ve done this for a patient, things have worked out fine, so it *must* be the right decision.”

It’s easy to think, as a rising second-year medical student, that many of the issues I’m learning about this week *will* apply to me in my *future* practice, but are not sins of which I… Continue reading →