Something to Talk About
Just a warning in advance, I apologize for the lengthy blog post!
In my health policy class, we watched a Ted talk called "How do we heal medicine?" by Atul Gawande- which I highly recommend watching if you haven't. Throughout his talk, he brings up extremely good points about how the medical system is broken, how expensive care is not necessarily the best care, how we want the best drugs, the best technologies, the best specialists, etc. The thing that stood out to me was when he brings up skills that a system should have. The two particular skills as a physician he says is "Find where your failures are and devise solutions". He brings up the time when World Health Organization comes onto his team to do a project that focuses on reducing deaths in surgery. "The volume of surgery had spread around the world, but the safety of surgery had not. The usual tactics for tackling problems like these are to do more training, give more people specialization, or bring in more technology" (Gawande, 2017). In the medical field, there are numerous of highly specialized surgeons and doctors who are the best at what they do. But even the best fall down, even they make a mistake that ends fatally. So Gawande and his team looked at skyscraper construction and the aviation world. The thing that made them different from medicine is the usage of checklists. A checklist wouldn't be the recipe of how to fly a plane, how to build a skyscraper or how to do open heart surgery- but it's a reminder of the key things that get forgotten or missed if they're not checked. He implemented this strategy in a variety of different hospitals around the world. What happened was shockingly miraculous- the complication rates fell 35% and the death rates fell 47%. Although this project was a success, it has been a slow spread throughout the medical field in actually applying it as the norm. Why? Gawande states, "there's a deep resistance because using these tools forces us to confront that we're not a system, forces us to behave with a different set of values. ....requires us to embrace different values from the ones we've had, like humility, discipline and teamwork. This is the opposite of what we were built on, independence, self sufficiency and autonomy".
... which brings me to my next point.
Shortly after watching Gawande's Ted talk, I came across another called "Doctors make mistakes. Can we talk about that?"by Brian Goldman. He discusses about the course of his career as a physician, about the mistakes he had made along the way. The first mistake he made was sending a woman home who had congestive heart failure, after prescribing her with medications to relieve the strain on her heart. Even then, he had a terrible gut feeling that something was going to happen. He discovers that an hour after she got home, she collapsed and she returned back to the hospital where she was put on a ventilator because she was blue and couldn't breathe. Nine days later, her family made the decision to take her off as she had irreversible brain damage. He was beating himself up over this, he felt like a failure and told himself not to let it happen again. What happened next? He made another mistake, over, and over, and over, and over, and over again. Goldman says "Errors are absolutely ubiqutious. We work in a system where errors happen every day, .... where hospital acquired infections are getting more and more numerous". In the United States, as many as 100,000 Americans die from preventable medical errors- according to the Institute of Medicine. But the thing is, he couldn't talk to his colleagues about it. How was he supposed to talk to someone about his failures as a physician, when he supposedly has this "God like power" and it's frowned upon for him to make mistakes? Therein lies the problem, our thinking has to change.
I know, you're probably thinking why I chose to talk about two different Ted talks about physicians? To me, these two Ted talks connect in a way that in the medical field, implementing a change can be a challenging thing to bear. Now, I'm not talking change in as discovering a cure for a disease and changing the treatment plan. I'm talking about change within the system itself, the doctors, the surgeon, or even maybe the hospital as well. I believe that a change needs to be implemented in the way a physician behaves and the values they were built on, a change in society's view that physicians are supposedly "God" with this remarkable ability to fix a human that is broken, a change in the way physicians approach to mistakes and implementing them.
Gawande, A. (2012 February). How do we heal medicine? Retrieved from
https://www.ted.com/talks/atul_gawande_how_do_we_heal_medicine
Goldman, B. (2011 November). Doctors make mistakes, can we talk about that? Retrieved from https://www.ted.com/talks/brian_goldman_doctors_make_mistakes_can_we_talk_about_that
In my health policy class, we watched a Ted talk called "How do we heal medicine?" by Atul Gawande- which I highly recommend watching if you haven't. Throughout his talk, he brings up extremely good points about how the medical system is broken, how expensive care is not necessarily the best care, how we want the best drugs, the best technologies, the best specialists, etc. The thing that stood out to me was when he brings up skills that a system should have. The two particular skills as a physician he says is "Find where your failures are and devise solutions". He brings up the time when World Health Organization comes onto his team to do a project that focuses on reducing deaths in surgery. "The volume of surgery had spread around the world, but the safety of surgery had not. The usual tactics for tackling problems like these are to do more training, give more people specialization, or bring in more technology" (Gawande, 2017). In the medical field, there are numerous of highly specialized surgeons and doctors who are the best at what they do. But even the best fall down, even they make a mistake that ends fatally. So Gawande and his team looked at skyscraper construction and the aviation world. The thing that made them different from medicine is the usage of checklists. A checklist wouldn't be the recipe of how to fly a plane, how to build a skyscraper or how to do open heart surgery- but it's a reminder of the key things that get forgotten or missed if they're not checked. He implemented this strategy in a variety of different hospitals around the world. What happened was shockingly miraculous- the complication rates fell 35% and the death rates fell 47%. Although this project was a success, it has been a slow spread throughout the medical field in actually applying it as the norm. Why? Gawande states, "there's a deep resistance because using these tools forces us to confront that we're not a system, forces us to behave with a different set of values. ....requires us to embrace different values from the ones we've had, like humility, discipline and teamwork. This is the opposite of what we were built on, independence, self sufficiency and autonomy".
... which brings me to my next point.
Shortly after watching Gawande's Ted talk, I came across another called "Doctors make mistakes. Can we talk about that?"by Brian Goldman. He discusses about the course of his career as a physician, about the mistakes he had made along the way. The first mistake he made was sending a woman home who had congestive heart failure, after prescribing her with medications to relieve the strain on her heart. Even then, he had a terrible gut feeling that something was going to happen. He discovers that an hour after she got home, she collapsed and she returned back to the hospital where she was put on a ventilator because she was blue and couldn't breathe. Nine days later, her family made the decision to take her off as she had irreversible brain damage. He was beating himself up over this, he felt like a failure and told himself not to let it happen again. What happened next? He made another mistake, over, and over, and over, and over, and over again. Goldman says "Errors are absolutely ubiqutious. We work in a system where errors happen every day, .... where hospital acquired infections are getting more and more numerous". In the United States, as many as 100,000 Americans die from preventable medical errors- according to the Institute of Medicine. But the thing is, he couldn't talk to his colleagues about it. How was he supposed to talk to someone about his failures as a physician, when he supposedly has this "God like power" and it's frowned upon for him to make mistakes? Therein lies the problem, our thinking has to change.
I know, you're probably thinking why I chose to talk about two different Ted talks about physicians? To me, these two Ted talks connect in a way that in the medical field, implementing a change can be a challenging thing to bear. Now, I'm not talking change in as discovering a cure for a disease and changing the treatment plan. I'm talking about change within the system itself, the doctors, the surgeon, or even maybe the hospital as well. I believe that a change needs to be implemented in the way a physician behaves and the values they were built on, a change in society's view that physicians are supposedly "God" with this remarkable ability to fix a human that is broken, a change in the way physicians approach to mistakes and implementing them.
Gawande, A. (2012 February). How do we heal medicine? Retrieved from
https://www.ted.com/talks/atul_gawande_how_do_we_heal_medicine
Goldman, B. (2011 November). Doctors make mistakes, can we talk about that? Retrieved from https://www.ted.com/talks/brian_goldman_doctors_make_mistakes_can_we_talk_about_that
Thoughtful and integrative post! Nice work.
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