My take-home points and remaining questions from today:
1. Transparency is critical when dealing with medical errors. We are doomed to repeat mistakes if we don’t learn from the past. Barriers exist, but when the focus is re-centered on patients, money and professional integrity fall into the right place.
What the patients and families want to hear after medical errors
2. Strategic negotiation:
Since coming back to my apartment, I’ve begun to reflect on some of the experiences from this past week of Telluride. Specifically, I’ve thought about what it will take to affect change at my home institution of Georgetown Medical School.
My mind keeps wandering back to a conversation I had with Michelle on Thursday night. We were both rehashing our outcomes from the X Y business negotiation game. I thought that I had a very clever strategy for success. Even though it ultimately failed, I thought that it was sound in concept. My approach was to feign misunderstanding about the rules for the first few rounds and throw the X card 4 times. Then I would act as if I finally grasped the rules and encourage everyone that it is for everyone’s benefit to throw only the Y card. I assumed everyone would see the benefit to this and then… Continue reading
I really enjoyed the negotiation exercises we had today. It was interesting to see the concept of negotiation broken down into such small pieces. The results of the Hamilton Estate case were intriguing. I managed to settle on buying the property for $45M, which I thought is a pretty good price. It was $15M less than my best alternative. Yes, it was slightly above the maximum value of the property today, but not too much. I thought I negotiated well and that I got a great deal; I am happy with it. It turns out though that that price is actually at just about the average at which the property was sold across the entire group. I was really surprised to hear that one person bought the property at $31.5M – that’s well below the best alternative option of the seller! I am not… Continue reading
Today I failed miserably in the art of negotiating. The Hamilton exercise validated how terrible I am and how much I lack the skills to be selfish and defend my qualities when it comes to negotiating a salary. I have had many opportunities in my short life to negotiate a salary and to be bluntly honest, I failed miserably at all of them. As Paul was explaining that most people avoid this type of exchange I started thinking about why do I have such a negative opinion of negotiations. I considered if it is because I enter this ritual with the predisposition that I have to do the numbers dance…. 35…30…34….32.5… , or that I expect some sleazy tactics to trick me, or is it that I view negotiating as a type of confrontation which I want to avoid at any cost. There was no process of elimination in my… Continue reading
Just finishing my first 24 hr call as “the” senior resident and Chief, I began my journey into Telluride completely exhausted. I was fully aware of my limitations as a human being, and my heart was still pounding thinking about the 18 patients whose lives had been entrusted to me overnight. However, I was joyful. I was not only going to a beautiful place that seemed to be the inspiration for all of Bob Ross’s masterpiece paintings, but also a place where I had hoped to develop and mature as a doctor–“Doctor” as defined by its rudimentary latin origin, “to teach”.
However, today’s experience was life changing. Today it was reaffirmed to me… Continue reading
Day one in telluride proved to be educational and inspiring. The negotiations piece by Paul Levy was interesting because I have never thought about how apparent negotiations are in our day-to-day lives. I also was never aware of the components of negotiation skills or their application to medicine. What an important life skill that I can continue to practice. C.U.S. is a new acronym to me but something I can see being easily applied to our new intern orientation next week. There were so many passionate and inspiring comments in the room. After a full day at the intermediate school I think we were all excited to share our passion and our personal experiences with patient safety and quality improvement at our home institutions. I had a great gondola ride with my fellow residents and I can sense a spark lit within all of us. I am looking forward to the week ahead!
Shelly Dierking is leading a workshop in conflict resolution today at the Telluride Patient Safety Educational Roundtable and Summer Camp. Residents are using role play of cases to highlight where conflict management breaks down and how best to build it back up.
What is coming to light is that there is variance that needs to be managed on a daily basis, and without teamwork and systems in place to manage and support those at the front lines, it’s only a matter of time before a tipping point is reached and the patient suffers. Not to mention the care providers who have the best of intentions, are human and who suffer along with their patients when an error occurs.
Dave Mayer and Tim McDonald opened the 8th Annual Telluride Patient Safety Educational Roundtable and Summer Camp. This being the eighth year the pair have taken time away from busy academic appointments, clinical responsibilities and family to continue to push forward in educating new physicians along with faculty on the just culture they know will make healthcare safe for all of us.
The residents and faculty were introduced to one another, and then we quickly moved into the week’s agenda starting with all viewing From Tears to Transparency: The Story of Lewis Blackman — a striking example of why we are all here and why there is still so much work to be done.
The residents kicked off the week sharing how some of their current environments were aware of the need for open and honest communication, yet failed to provide the support when an opportunity to have that conversation… Continue reading