Patient Centered Care

Changing My Practice After Telluride

After my time at Telluride, I only had one day to process everything we learned, and then got right back on the horse and went back to work in the Emergency Department. I truly felt like I was seeing my clinical practice from a new angle. Rather than completing tasks and checking boxes, I found myself thinking through clinical situations and inviting patients and family into conversation about their care.

Of everything that we experienced at Telluride, I am most thankful for the opportunity to learn from the Blackman and Skolnick families. My heart is broke for these two young men and their families, who put their faith in healthcare members, who they should have been able to trust. I learned from their stories that open and honest communication with patients and families, from the very beginning (in my case, the ED waiting room) … Continue reading

That Creeping Feeling…

First of all, I want to say that Richard’s presentation was so phenomenal today. I distinctly remember hiking up the San Juan mountains in Colorado at last summer’s Telluride conference after a great session the day before thinking, “I’ve found my people.” It really is a special thing. I still see one of the other alums every now and then at hospital meetings and it literally warms my heart to hear his name and that he is doing great things at his home institution.

We talked a lot about informed consent and a patient’s understanding of their own experience in the healthcare system. As a primary care physician, I couldn’t help but wonder how Patty’s son’s primary care doctor felt about the horrific outcomes of his patient at the hands of a surgeon who probably didn’t need to operate in the first place, someone he tried to… Continue reading

I Have A Question…Is That OK?

Throughout today’s discussion various moments truly hit home to me, especially in regards to communicating with patients and families. People come to hospitals often in their most dire time of need, not to simply chat and sip coffee. Stress, fear, anger, and uncertainty mar the face of these individuals, leaving them to appear disfigured in comparison to their standard facade…leaving them at their most vulnerable. As healthcare workers it is our duty to identify that these people are hurting and understand that communication can assist in stopping the hemorrhage of “what if’s” and begin to help with the healing process.

Bringing to light that it is normal for individuals to have questions, I feel, is so important. As it was examined today, asking patients and families “what concerns you?” or “what bothers you about this?” truly provides an opportunity for individuals to stand up for themselves without feeling the pressures… Continue reading

Who’s on the Team?

As an incoming second year medical student, I hardly have any clinical experience. My school is beginning to stress the importance of interprofessional education and emphasizing how everyone from the housekeeping staff to the administrators is important in the healthcare team, and I see the importance of each person’s role. However, one piece of the team is rarely discussed – the patient and his/her family. When we reviewed the Lewis Blackman story today, it was discussed how his mother, Helen, was the only constant in his care. Helen, her husband, and Lewis were the only people who witnessed the entirety of the very fragmented care that he received. I have heard that patients and their families are supposed to be a part of the health care team, but I did not truly understand what their role was other than making the final decision on treatment plans. Now I understand that… Continue reading

“It’s the System”

I needed a few days after being at Telluride Summer Camp to let the experience settle in. It was a whirlwind of heart-wrenching stories, connections, and thought-provoking discussions. As a second-year resident, I came to Telluride with the baggage of a traditionally difficult intern year, with the baggage of having lost my grandfather due to a multitude of systematic medical errors, and the viewpoint of having been a nurse prior to medical school. I needed to see a room full of people that don’t accept the phrase, “that’s just the system we’re in.” I had grown tired and had half-way accepted that answer, so it’s amazing to see the influence that a group full of inspired professionals can do. Every time I spoke to someone new I was blown away by their dedication and drive. Every person in that room, from all types of training… Continue reading

Day 3: Just Culture

Today we talked about just culture. We talked about the importance of leadership. The quote I will take with me from today’s presentation, “having the kind of leadership and leadership not being about punishing and blaming but about using every single instance of anything gone wrong as a process of learning from the event.” I want to take this quote with me, and remember about the leaders I admire as they lead by example. Often it is easiest to blame the person or the problem, but often discovering the problem is easy. But what are we doing to fix the problem? How can we, as individuals, go about a resolution to a problem alone? Instead of doing it alone, don’t look at one part of the process to blame, but instead the systems that were established, that don’t prepare us with the tools to succeed. We must come together; analyze… Continue reading

Day 2 Reflection: Michael Skolnik and the problems we have with the process of obtaining informed consent

Today we discussed Michael Skolnik’s story and really touched on the process of informed consent. As a nurse I am a witness of informed consent and I have been identified by some as to “who not to ask to be a witness to an informed consent” form by some physicians in my practice. Often times, as many of the residents in the program identified, informed consent is one of the many tasks that physicians have to check off their list throughout the day. First off, I will not sign an informed consent if I was not in the room during the process of obtaining an informed consent. I also want to make sure the patient’s, or their families/POA, are able to state the procedure in their own terms, and every risk or benefit that accompany each procedure. If they cannot, I will have the physician restate or rephrase whatever part… Continue reading

Telluride @ Napa Day 2 Reflection: From a Movement to a Mentality

Similar to the previous day, I found myself incredibly moved by the film presented regarding Michael Skolnik’s experience and subsequent death. While I was shocked to learn of the neurosurgeon’s actions and attitude during the whole ordeal and resulting consequences, I was truly surprised by the number of conference participants who could identify an instance when they had encountered or interacted with a similar physician. It seems like common sense that in a field dedicated to improving people’s health, all of the members in the profession would require basic traits such as compassion and empathy to succeed. Yet, I am instead hearing of countless examples where the opposite is true, and it leaves me dumbfounded.

The paternalistic model of patient-doctor communication has allowed the past generation of physicians to build an exaggerated sense of self-worth and importance, given the authority to quite literally dictate the lives… Continue reading

The movement of change

 

Just like in the video of the shirtless dancing guy where a first, then a second, then more and more followers joined in the movement voluntarily and with excitement and created this momentum where change was in effect, the change in the culture of healthcare is happening and it is about time.

I am proud and happy to be part of the movement of change, changing this centuries-old culture of practicing physician-centered paternalistic medicine and finally focusing on what matters the most: the patient.

 

Crying Wolf

This post is a day late in coming, but it’s still a relevant concern of mine.

Yesterday was the first day of our patient safety camp/conference, and we spent a lot of time talking about communication and speaking up if you see something going wrong, especially if you’re lower down the hospital hierarchy.  As a medical student, I imagine this scenario as a med student or a resident doing rotations in the hospital.  Being the med student who doesn’t know anything or the new resident who’s green, I can easily imagine situations where I might think something’s off with our diagnosis or treatment plan for a patient, and my concerns are brushed aside as the concerns of an inexperienced learner.  At some point, hopefully, I’ll be lucky enough to work with an attending who does listen to me when I raise a concern, but the tricky thing… Continue reading

Telluride Experience 2021 Dates

BRECKENRIDGE, CO:
CMF Session One*: 6/7 – 6/10
Bennathan Session Two: 6/14 – 6/17
Session Three: 6/21 – 6/24

*Session exclusive to the COPIC Medical Foundation Residents.
 
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