“Grades don’t have a lot of meaning,” says Dr. Sara B. Fazio, associate professor of medicine at Harvard Medical School who leads the internal medicine clerkship at the Beth Israel Deaconess Medical Center in Boston. “‘Satisfactory’ is like the kiss of death.”
As I have mentioned before, all surgeons think they are the best. Of course when we ourselves need surgery, there is a bit of a dilemma deciding who is the best qualified to carry out the procedure. So when I realized there was a strange looking skin lesion in my right inner thigh, I decided only the best would do to operate me.
Could something like this happen in medicine? It might not be exactly the same, but an interesting dilemma is looming.
Information technology in healthcare is still stuck in the 1980s. As an emergency room physician, I can attest that the technology we do have does more to slow me down than help me deliver better, more efficient care.
Doctors do stuff — tests, procedures, drug regimens, and operations. It’s what they’re trained to do, what they’re paid to do and often what they fear not doing. So it’s pretty significant that a broad array of medical specialty groups is issuing an expanding list of don’ts for physicians.
A study concludes, “Additional work must be undertaken to identify strategies to optimize operating room efficiency and to develop alternate strategies to prepare participants for the performance of the procedure.” And what would those “alternate strategies” be? You can pick up beads on a simulator all you want, but it’s not the same as doing an operation. And assuming open surgery is still being done somewhere, there is no simulator for open surgery.
The X-Files fans will remember the poster that Agent Mulder had on his bulletin board with a picture of a flying saucer and the words, “I want to believe.” That’s how I feel reading EMR notes sometimes. I want to believe, but I doubt.
Experimentation in one’s career path has become a natural process. Learning new skills is a constant; adapting to new environments is mandatory. But is the healthcare workplace environment ready to adapt? Probably not as well as it could or should. Here are five critical ways the modern healthcare workplace can adapt to this rapidly evolving healthcare workforce.
Memories of a past conversation I had came flooding back last week when I read an essay on the problems posed by hierarchies within the medical profession.
EMRs are essentially electronic charts, but what we need going forward is a tool to promote accountability and measurement of quality and safety.
One afternoon my colleague revealed that she had been named in a lawsuit, accused of overlooking an irregularity on a scan several years earlier. The plaintiff suing believed my colleague had missed the first sign of a now rampant cancer. While other radiologists tried to assure her that the “irregularity” was well within what might be considered normal, my colleague became consumed by the what-if’s.
We will continue to worry whether the healthcare system upon which we depend will eventually make it impossible for us to feel safe and secure as they approach the end of our lives.
For years we’ve read that the US faces a looming shortage of nurses. Yet somehow 43 percent of newly-licensed RNs can’t find jobs within 18 months. Some hospitals and other employers openly discourage new RNs from applying for jobs. That doesn’t sound like a huge shortage, then does it?
For most people, anesthesia is one of the more mysterious branches of medicine. What we do for patients is done, generally, when they are asleep. We have done our job right if our patients don’t remember most of what we did.
We should acknowledge that there might be cause, ethically, to deploy a technology that truly benefits patients at some cost. After all, you have to break a few eggs to make a good omelet. If interoperability of EMR systems between facilities were commonplace and clinical data were shared with ease while patient privacy was vigorously upheld flawlessly, the cost of these systems might be ethically justified.