This is trending on Hacker News. Be sure to go there and look at the comments, they are long and often from doctors. This audience needs to read them. Dr. Stillman, I am a pulm/ CCM physician trained in the 1980’s, trained at the best institutions, trained many med students, residents, fellows in a number of states, in a variety of settings. This article really resonated with me. How do physicians like me contact you directly to share ideas and move the practice of medicine forward so that the environment we practice in is one in which we ourselves would be comfortable receiving care. For example, a concept that no one is formalizing is ADVOCACY which is what you are doing with every encounter with your husband and what we provide when our families and friends need medical care and contact us. This is the way that we ourselves navigate this complex system. Patients and families are thrust into a system which demands that they immediately and inherently TRUST the provider / system. With the right ADVOCATE this is possible. Again, how do I reach you directly?
Hi Bess - My brain's blown from nodding and the complexity. My Dad was a consultant geriatrician in the local hospital until he retired so I've seen how it operated way back when. Then, he was in and out for operations and 2018-2020 we were in and out of ER. A few times we were blue-lighted in just after midnight, and a bed wasn't available in cardiac until early afternoon the next day (after morning rounds pushed discharges). The sleepless nights were in ER, hospital wards and at home.
As Dad had a complex set of comorbidities MANY times I had to be his champion. The subrenal abdominal aortic aneurysm is low on the list and will NOT be treated when his arrhythmia and heart failure is unstable, due to his bladder cancer. The fact I had to repeat info around 4/5 times per visit AND that the local hospital only started using iPads in Dec 2020 (blue lighting Mum) highlights how tough it is for patients AND everyone in ER at the hospital.
There is so much I could share. Your messages are SO important to raise awareness.
I love what you wrote, indeed everything that you write. And the fact that you write it. The thought occurred that the system no matter how "dumb" from a human perspective is going to change voluntarily. Did you ever wonder why we all collude in the creating and sustaining of this "dumb system" that is designed to disconnect us from each other and ourselves?
"Until incentives align, and the hospitals reward and pay physicians for doing the work of educating in addition to their clinical work; until teaching attendings have adequate training on how to educate; until hospitals are willing to staff adequately so there’s time to teach, the system will remain broken."
This is trending on Hacker News. Be sure to go there and look at the comments, they are long and often from doctors. This audience needs to read them. Dr. Stillman, I am a pulm/ CCM physician trained in the 1980’s, trained at the best institutions, trained many med students, residents, fellows in a number of states, in a variety of settings. This article really resonated with me. How do physicians like me contact you directly to share ideas and move the practice of medicine forward so that the environment we practice in is one in which we ourselves would be comfortable receiving care. For example, a concept that no one is formalizing is ADVOCACY which is what you are doing with every encounter with your husband and what we provide when our families and friends need medical care and contact us. This is the way that we ourselves navigate this complex system. Patients and families are thrust into a system which demands that they immediately and inherently TRUST the provider / system. With the right ADVOCATE this is possible. Again, how do I reach you directly?
Hi Bess - My brain's blown from nodding and the complexity. My Dad was a consultant geriatrician in the local hospital until he retired so I've seen how it operated way back when. Then, he was in and out for operations and 2018-2020 we were in and out of ER. A few times we were blue-lighted in just after midnight, and a bed wasn't available in cardiac until early afternoon the next day (after morning rounds pushed discharges). The sleepless nights were in ER, hospital wards and at home.
As Dad had a complex set of comorbidities MANY times I had to be his champion. The subrenal abdominal aortic aneurysm is low on the list and will NOT be treated when his arrhythmia and heart failure is unstable, due to his bladder cancer. The fact I had to repeat info around 4/5 times per visit AND that the local hospital only started using iPads in Dec 2020 (blue lighting Mum) highlights how tough it is for patients AND everyone in ER at the hospital.
There is so much I could share. Your messages are SO important to raise awareness.
You articulated so many of my thoughts in this piece that I’m saving to re-read. I’m so glad to have found your work.
I love what you wrote, indeed everything that you write. And the fact that you write it. The thought occurred that the system no matter how "dumb" from a human perspective is going to change voluntarily. Did you ever wonder why we all collude in the creating and sustaining of this "dumb system" that is designed to disconnect us from each other and ourselves?
I completely agree with Susan K.
"Until incentives align, and the hospitals reward and pay physicians for doing the work of educating in addition to their clinical work; until teaching attendings have adequate training on how to educate; until hospitals are willing to staff adequately so there’s time to teach, the system will remain broken."
This was an extremely important message. Thank you