My biggest takeaway from our Day 3 discussions was this important facts: our patients are people.  They are not their disease.  They are not the grouchy/tired/scared/stressed mood that they are in during our brief encounter.  They are not the poor historian, the lady who refuses X treatment, or the chain smoker in room 304.  They are Claire and Sally and Scott and Jim.  They are somebody’s child.  They are somebody’s friend.  They have hopes and dreams and fears.  They have a story that extends far beyond their HPI or this hospital stay or whatever chronic condition their PCP helps manage.  We only see a small sliver of their experience and yet we assume that we know what is best for them.

On the surface, listening to your patient’s story doesn’t seem particularly relevant to patient safety.  Certainly not when it… Continue reading →

Today we talked a lot about shared decision making.  We often want patients to agree with what we think is best, but what we think is not always correct or in line with what the patient values.  We are not here to act out our will.  We are here to help our patients enact theirs.  Certainly we should educate them.  If their initial preferences seem to be uninformed or rooted in fears we can alleviate we shouldn’t just wash our hands of the matter in the name of patient autonomy.  But we absolutely cannot inflict our values on them because “doctor knows best.”

Shared decision making takes time.  Time most healthcare workers feel they do not have.  After today’s discussions, however, I feel it is definitely time well spent.  Not only is it the ethical thing to do, I think it… Continue reading →

Be humble.

That, to me, is the number one rule of patient safety.  Be humble to know that you don’t (and can’t) know everything.  Be humble to accept change.  Be humble to listen to the input of others.  Be humble to show gratitude to those around you.  Be humble to admit your mistakes.  Be humble to appreciate the magnitude of the trust placed in you.

Humility is hard, especially in medicine.  After going through such rigorous training you want to feel proud of your accomplishments and knowledge.  As you should.  You want to be sure in your diagnostic capabilities and treatment plans.  You want patients to trust your expertise.  You do not want to seem incompetent or indecisive or foolish.  Confidence and humility are not mutually exclusive, but they are difficult to balance.

Our culture needs to change.… Continue reading →