What a mess!

What the hell were we/they thinking? Maximize profits at what expense?

The assembly line model for patient care will lead to medical errors and missed diagnoses, not to mention terrible patient satisfaction.

Observations in Training

"Learning how to practice medicine is not easy. There is a tremendous amount of information thrown at us. I am constantly balancing medical school coursework, exciting extracurricular experiences that enrich my learning and prepare me for residency applications, and personal relationships that keep me grounded. At times, though, it feels like I'm running out of energy and that too much is being asked of me. This feeling is not unique to medical trainees. Anyone developing a skill or portfolio at the beginning of their career works exceedingly hard to develop mastery of their craft, and that often takes a toll." - Nihar Rama

Reflecting on the reflection I recognize the toll that medicine and medical education took on my and my colleagues. We have become fried by the system, unable to stay grounded, tossed by the ocean of change and stresses upon us through many unnecessary discomforts.

Dr. Lisa Rosenbaum, in the New England Journal of Medicine, writes of the tensions between the rigor of medical training and how many trainees are pushing back against the demands of the profession. She writes, 

"…Maintaining our commitment to excellence while remedying our failures requires distinguishing unnecessary harms from necessary discomforts."

My generation of clinicians has been unnecessarily harmed, in irreversible ways. I've always hoped that the new generation can reverse this phenomenon in order to help recreate the system that has become sick-care in the United States and beyond. 

 

There needs to be much less "unnecessary harms" to save the system from completely drowning in and upon itself.

Think Blue!

Want to live long and prosper? Think Blue.

Blue Zones, regions of the world where people live exceptionally long lives, ten times more likely to live to 100 - Barbagia region of Sardinia, Italy, Okinawa, Japan, Nicoya Peninsula, Costa Rica; and Icaria, Greece

1. Move naturally

• "soleus push-ups" (calf raises) in a sitting position
• opt for walking or biking for short distancesleg lifts or seated stretches
• take the stairs

2. Say yes to happy hour

• moderate alcohol consumption often occurs in a social context, emphasizing the role of community and celebration

3. Take time to down shift

• take a deep breath, hold for a few seconds, and slowly breathe out through your nose

4. Give your diet a plant slant

• plant-based sources of protein, like beans, including black, soy, fava, and lentils, over meat
• 3- to 4-ounce serving of pork

5. Find your crew

• love and positive social interactions have been shown to release oxytocin, reducing stress w/ long-term improvements in emotional state and physical health

6. Abide by the 80% rule

• stop eating when stomach is 80% full

7. Put your loved-ones first

• investing time in your family 
• keep aging parents (or grandparents) nearby
• commit to a life partner
• children, make an effort to spend time with them

8. Find a place you belong

• attending a faith-based service four times per month could add four to 14 years to your life expectancy
• seek out a squad that makes you feel accepted and seen

9. Know your "why"

• purpose in your day-to-day life
•     What do I love? (Passion)
•     What am I good at? (Profession)
•     What does the world need? (Mission)
•     What can I be compensated for? (Vocation)

Time to take account and seek the "blue" proven ways to age strongly and gracefully.

Ugh

As I write this, I have been sitting in an emergency department with a family member for almost 14 hours, suffering from up charges for a simple procedure in the morning.

I can't tell you how broken the system is because the disrepair is beyond repair. The rooms in the hospital are filled up and patients line the walls on gurneys with the beep beep sound of EKG alarms blaring. Every 10 minutes or so some employee comes over to the cabinet across the hall from our gurney and looks for equipment that is not there. Wasted time and effort. Frustration beyond belief. 

Nobody looks happy.

It's no wonder people get sicker when they come to the hospital. The staff is overworked. The equipment is absent. The system is overwhelmed, broken and without hope as populations grow and resources become more scarce in relation to the strain of perceived community needs. 

We are screwed!

But in a pure irony of need, a new building is being built on the property to accommodate the growing need for sick care. A building that will likely be filled with patients, not enough staff searching for inadequate equipment.