Mea sententia...

Mea Sententia translates roughly as 'My Opinion' and has been my intermittent blog since 2011. Much of my writing is about medical issues, but my topics range through philosophy, behavioral and decision making, management, humor, and personal/family anecdotes.


Progress: a bar of soap

I keep a bar of soap in my desk at the office as a reminder of progress in medical care. It was my grandfather’s idea.

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Delusions. If you can't beat them, sometimes you have to join them.

It played out more like a television skit than most television skits. I wouldn’t believe it myself had I not been there.

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“When you pay a lot of money for bullshit, you have to pretend you like how it smells. To do otherwise is to admit you were wrong, and that is not allowed in management.”

From STAR-Whacked at Trustus Pharmaceuticals. 



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Thought for today

Life must be understood backward. But it must be lived forward. (Soren Kierkegaard)

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Some thoughts about ADD/ADHD

I struggle with how best to approach attentional issues in my practice. I was taught by a developmental pediatrician in Madison that (diagnostic) labels were a convenience invented to make things simpler for clinicians and the billing office, but that they are of limited clinical value. and often actually harmful to patients. His concerns centered on the dangers of standardization and the dead-end effect. Treating the label distracts from seeing and treating the patient as a unique individual in a unique context with an individual manifestation of X.

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The impact of errors in medicine

Not all errors have negative consequences. Many go unnoticed. Occasionally they save lives.

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Small talk is not a small thing

In medicine, as in life, it is often the little things that matter.

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Why I argue

I have been called argumentative, disputatious, a vexatious nuisance, oppositional, a disagreement looking for an opportunity, and far worse.

 With these descriptions, I would not argue. The folks who say these things are correct. But I wonder if they know why I like to argue?

Not to win. Not to prove a point. Not to sell a position. Not to convince.

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Unintended consequences of the EHR

Even if the eHR is only used as a word processing and data repository - in which case it is a very expensive technology used to duplicate the paper world - the impact on work flows would be substantial. Using the eHR as a catalyst to improve care means dramatically re-engineering huge segments of the care process. Either way, unintended consequences are inevitable.

So, what might a practice or medical center do to minimize the risk of harm from unintended consequences?

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Honor the heretics

In an organization – as in society – there is an important distinction between faith and religion. 

Faith is belief in the organization’s mission, supported and embodied in its values and long term goals. In a successful organization, faith is a common good, co-owned and held by the entire community.  Leadership doesn’t own or control faith, but functions as steward and guide, helping the community stay connected with (and by) their shared faith.

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