My blog represents my personal experiences and perspectives. This includes many anecdotes from my life and from my medical practice. I have been scrupulous to anonymize all medical anecdotes and to avoid ever belittling or making fun of patients. (I often make fun of and criticize myself, my colleagues, and the institutions where I have worked.)
"Faced with the choice between changing one's mind and proving that there is no need to do so, almost everyone gets busy on the proof."
John Kenneth Galbraith, economist (1908-2006)
This imaginary letter, penned after attending a Quality Initiative meeting, is fictional today, but I suspect something like it will appear in the near future and be sadly common within five years. I hope I have retired by that time, because it would be truly shameful to actually sign and send such a letter.
Dear (computer generated patient name),
I am writing to express my deepest regret that I can no longer serve as your PCP. I will continue to provide you with all appropriate care during the next sixty days while you arrange an alternative provider.
This imaginary letter, penned after attending a Quality Initiative meeting, is fictional today, but I suspect something like it will appear in the near future and be sadly common within five years.
This folk wisdom is variously attributed to Sun Tzu (The Art of War), Carl von Clausewitz, Mae Zedong, and the heavyweight prizefighter Jack Dempsey. Regardless of origin, it deserves its place in the pantheon of behavioral truths.
During a recent conversation with a patient about her irritable bowel syndrome, I asked about possible stressors:
“So, tell me, I know it’s hard to manage both full time school and a part time job, but I wonder if there are any other things going on for you that you wish you could change?”
“And God created the organization and gave it dominion over man.“
(attributed to Peter Townsend)
“And God created the organization and gave it dominion over man.“
(attributed to Peter Townsend)
Top-down and centrally controlled leadership/management has predictable (negative) results as outlined in the graphic below the fold…
Every physician has a few stories of things that are funny or amazing, in retrospect, but were less so at the time. Many of these are of questionable taste. This is one of those stories. Read on at your own risk – you were warned.
Moderation (or centrism in the political world) is best defined as a slavish devotion to the status quo.
Which approach seems right to you? How do you maintain a balance?