As our final week of the 2015 Telluride Experience comes to a close, our Telluride blog has been nourished by a new year of talented healthcare trainee reflections. Many of these young physicians and physicians-in-training, along with their nursing colleagues, have submitted reflections that we will share more on moving forward, but they can be viewed here today.
Because our scholars and Alumni often return to the ETY blog as a reference tool, we wanted to share another opportunity for all to showcase their passion and commitment for keeping patients safe through writing. The Doctors Company Foundation, an organization that also sponsors a number of medical student attendees to participate in our Academy for Emerging Leaders in Patient Safety each year, is once again partnering with the Lucian Leape Institute at the National Patient Safety Foundation (NPSF) to offer The Doctors Company Foundation Young Physicians Patient Safety Award. The award will recognize young physicians for “their personal insight into the importance of applying the principles of patient safety to reduce the incidence of medical error.” Applicants are invited to submit essays of 500-1,000 words about a patient safety event they personally experienced during clinical rotations that resulted in a personal transformation.
More information can be found on The Doctors Company Foundation website. A short summary follows:
Applicants are invited to submit essays that will be judged by a panel identified by NPSF. Six winners of this prestigious award will be selected and receive a $5,000 award, which will be presented at the Association of American Medical College’s (AAMC) Integrating Quality meeting in Chicago, June 2016. Nominations must be submitted by 5:00pm ET, Monday Jan 25, 2016.
- As of July 1st, 2015, applicants must be either a 3rd or 4th year medical student at an American medical school
- Award is for the best essay explaining your most instructional patient safety event experienced during a clinical rotation and that resulted in a personal transformation
- Award will be presented by The Doctors Company Foundation at AAMC’s Annual Integrating Quality meeting in Chicago
- Registration, hotel and travel will be covered to the AAMC meeting for Award recipients
Examples of winning essays from 2014 can be viewed via a past ETY posts (click here), and a review of the 2015 Essay Winners will soon follow. For additional questions, visit The Doctors Company Foundation website, here. We know there are many Telluride Alumni deserving of an award like this so please enter, and share the patient-centered care you are working so hard to make standard of care. Good luck!
Because so many of our readers are compassionate young physicians, and physicians-in-training, we wanted to share another opportunity for you to showcase that passion and commitment for keeping patients safe. The Doctors Company Foundation, an organization that also sponsors a number of medical student attendees to participate in our Telluride Student Summer Camps, is partnering with the Lucian Leape Institute at the National Patient Safety Foundation (NPSF) to offer The Doctors Company Foundation Young Physicians Patient Safety Award. The award will recognize young physicians for “their deep personal insight into the significance of patient safety work.”
Applicants are invited to submit essays that will be judged by a panel identified by NPSF. Six winners of this prestigious award will be selected and receive a $5,000 award, which will be presented at the Association of American Medical College’s (AAMC) Integrating Quality meeting in Chicago, June 12-13, 2014. Nominations must be submitted by 5:00pm ET, Monday Feb 3, 2014.
- As of June 2013, applicants must be either a 3rd or 4th year medical student or a 1st year resident in hospital setting
- Award is for the best essay explaining your most instructional patient safety event during a clinical rotation-one that resulted in a personal transformation
- Award will be conferred by The Doctors Company Foundation in partnership with the Lucian Leape Institute at AAMC’s Integrating Quality meeting in Chicago
For an example of this year’s winning essays, click here. Please contact us or visit the websites if you have questions! We know there are many Telluride Alumni deserving of an award like this so please enter, and share the patient-centered care you are working so hard to make standard of care. Good luck!
Humanism in Medicine Essay Contest Winner David Duong On Fear, Trust & the Love That is Patient-Centered CarePosted: November 25, 2013
A recent post on the AAMC blog AM Rounds, 2013 Humanism in Medicine Essay Contest: Caregiving As Good Doctoring, shares a recorded version of David Duong’s essay of the same name. Duong, a third year student at Harvard Medical School, earned 2nd place in the Arnold P. Gold Foundation sponsored contest by responding to the call for essays reflecting on “…the barriers to humanism in medicine today…and…who the ‘good’ doctors are.”
In his essay, Caregiving as Good Doctoring, Duong describes the fortuitous experience of serving as translator by default being the only Vietnamese speaker available to a family in need of assistance at his training hospital. The patient, Mr. N, was flanked by eight family members all earnestly trying to understand options around end-of-life care for their father succumbing to Stage IV colorectal cancer. It was Duong’s job to gently translate details given by the attending physician, and as he describes, guide the family through this emotional time.
As Duong retells the story of his time with Mr. N’s family, it is apparent he has learned firsthand the personal and professional ‘benefits’ that result from more intimately participating in the healthcare journey of patients. Following are excerpts, but the full essay is one worth reading in its entirety, as well as shared with caregivers young and old throughout the health sciences. Research may exist that supports empathy to be lost by the third year of medical school, but Duong’s words that follow speak to an awareness and empathy of someone firmly grounded in what it means to “walk with you and yours through this (healthcare) journey”. Enjoy!
…In this intimate role as a caregiver, I am reminded of a phrase in Vietnamese that people offer each other at grave moments, when life seems beyond our control, when long-fought battles are lost, or when death takes its final grip: “chia buồn” or “share in the sorrow.” The phrase means that we share in the emotions, the experiences, the bullets that life fires at each of us. The phrase, gently intoned, is intended to ease the burden, to say, “I am here and will walk with you and yours through this journey”…
…What an honor, a privilege, and at times a burden, it is to undertake a profession that constantly invites us to engage and intersect with humanity at its most fragile moments. Therefore, it is our privilege and responsibility as good doctors and medical caregivers—along with our colleagues in social work, chaplaincy, and nursing, among many others—to strive to deliver the best care to our patients. In Dr. Francis Peabody’s statement to the 1925 graduating Harvard Medical School Class, he averred that “the secret of care for the patient is in caring for the patient,” which resonates with our 21st-century mainstream society rhetoric of the “patient-centered” approach. It is not surprising, then, that the highest ideals in medicine have remained constant…
..Throughout my third year of medical school, I have realized that there is no medicine to alleviate fear—the fear of illness, the fear of your body in someone else’s hands, or the fear of dying. But I have also learned that by caring for the patient, by placing the patient at the center of our medical practice, we can establish a trust relationship that just might lessen that fear. By doing so, we humanize our practice, share in the life of our patients and, in return, grow more deeply human…
This year’s annual AAMC meeting is in full swing in Philadelphia, and you can join the conversation on Twitter via hashtag #AAMC13 to see highlights. The theme for 2013 is The Change Imperative and the meeting agenda, which runs through Wednesday, includes the following speakers who will without a doubt engage audiences in thought-provoking sessions on what the future of medicine and medical education will look like:
- Darrell Kirch, AAMC President kicked off plenary sessions Saturday, 4pm to discuss Our Moment of Truth
- Ian Morrison, Healthcare futurist and author, shared “his perspective on the rapidly changing landscape of health care, the impact of the Affordable Care Act on academic medicine, and how our community might leverage changes in the marketplace to help shape the future of medicine” on Sunday morning
- Anna Quindlen, Pulitzer Prize winning journalist and author, was scheduled for Sunday morning to discuss, Health Care in an Information Age: How Doctors, Nurses and Consumers Can Make One Another Better
- Daphne Koller, Professor of Computer Science, Stanford University and Co-Founder/Co-CEO, Coursera, discusses Exploring Changes in Education: Is Academic Medicine Ready for MOOCs? (Monday, Nov. 4th, 4pm)
- Adam Grant, Professor, The Wharton School of Business, University of Pennsylvania and author, Give and Take: A Revolutionary Approach to Success, will speak on Embracing Changes in Culture: Driving Organizational Success by Building a Culture of Contributors (Tuesday, Nov. 5th, 4pm)
For final program, click here.
On Tuesday, November 5th, winners of the AAMC “Light-years Beyond Flexner: Academic Medicine in 2033” video contest will also be announced. Medical schools were invited to create a 2-minute video envisioning what US medical schools will look like in 2033. Following is one example from Baylor University who believes three areas of competency physicians of the new age will need to be well versed in are: 1) Network awareness; 2) Information management, and; 3) Digital content creation. Finalists include:
- Eastern Virginia Medical School
- Meharry Medical College
- Temple University School of Medicine
All submissions can be viewed here.
I continue to enjoy following all the quality and patient safety work being led across the country by resident physicians. Many have come into healthcare with a much different perspective regarding quality, safety and outcomes than my generation did years ago. Be it the daily focus by the media on preventable medical errors, required transparency of outcomes, or the newer reimbursement models based on quality and safety, this new generation of physicians is asking the right questions and looking for the right solutions. It is why the premise “Educate the Young” is such a critical component to any enduring culture change.
In this spirit, we want to share another wonderful example of how resident physicians are changing the landscape of quality and safety in healthcare for the better. The AAMC webinar highlighted below, The House Staff Patient Safety Council: Creating a Culture of Safety and Openness, is being led by Nate Margolis and Say Salomon, both Telluride Patient Safety Summer Camp Scholar Alums, who are helping inspire resident physicians on how to lead change in their own academic institutions. What a great example of “pushing it forward”.
Date and Time: Wednesday, October 30, 2013 3:00 pm ET
Duration: 1 Hour
Description: In support of the Best Practices for Better Care Initiative commitment area to teach quality and patient safety to the next generation of doctors, this webinar will spotlight two institutional approaches to creating a culture of safety and openness by leveraging House Staff Patient Safety Councils to improve care processes and outcomes.
House staff patient safety councils create a culture of safety, engage residents in process improvement, and help satisfy ACGME requirements. A successful resident driven project will be described in which the distribution of badge buddies, incident report guidelines, and an incident reporting presentation increased house staff adverse event reporting in a 3-hospital academic program. In addition, the Safety Council activities and outcomes from Woodhull Medical Center will be shared. Some examples of their core projects include: the triaging of critical care value from an ambulatory care clinic, standardization of hand off processes and just culture conferences to improve quality of care delivered to its patients.
–Nate Margolis, M.D., is a chief resident in Radiology and the co-chair of the House Staff Patient Safety Council at NYU, Bellevue & Manhattan VA hospitals
–Say Salomon Jr., M.D., is an Associate Chief Resident in Internal Medicine at Woodhull Medical and Mental Health Center
To register, click here. It should be a great discussion!
Having moved to Baltimore about a year ago, I couldn’t help but enjoy watching last Sunday’s AFC Championship game. While the Chicago Bears will always be my number one football team, I have enjoyed following the Baltimore Ravens through their relatively short NFL history because like the Bears, the Ravens have a “blue collar” work ethic–built on strong, physical defenses led by all-pro middle line-backers. Plus my wife’s family is from Baltimore so our Sundays have always had some element of purple to them–even while living in Chicago.
What really struck me though was the trophy presentation and interviews in the Baltimore locker room after the game. Winning teams always talk about the “great chemistry” the team shares–players and coaches expressing admiration for each other–but this locker room was different. It felt different from the 1985 Super Bowl-winning Chicago Bears, different from last year’s New York Giants’ press coverage. I could feel something more powerful coming through the Ravens players’ interviews. From the owner, to the coaches and down through the players, they all talked about the love and respect they had for each other, and how they always had one another’s back–in good times and bad. It was different…
Having had the opportunity to meet and talk with John Harbaugh, the Ravens coach, at a fundraiser right after moving to Baltimore, it was clear he is the “real deal”. Coming from a family of great football coaches (John will face brother Jim and his 49er’s en route to a Superbowl championship in what sports pundits are calling the Harbowl or Superbaugh), one could easily tell that being an NFL coach was his true “calling” in life, and what he loved doing most. But it was more than just coaching–it was clear his passion was leading from the heart and serving as a role-model and mentor to the young men on his team. He was humble, caring, and passionate about football–and by the smile on his face when he told stories about his players, you could tell he really loved them. He had no ego, a wonderful sense of humor, and repeatedly poked fun at himself and his own weaknesses. By the end of that evening, I could see why the Ravens players also loved and respected him, and took to his leadership style. It was clear he could be a great leader at any Fortune 500 company.
The Ravens post-game locker room celebration this weekend reminded me of my encounter with John Harbaugh, and about my recent discussions on 21st century healthcare leadership. As in football, it starts with higher ground leadership qualities, and the increasing call for leadership from the heart that inspires others to greatness, and in so doing, brings joy and meaning back into the patient care environment. Those of us that have attended any of the annual Institute for Healthcare Improvement (IHI) meetings over the last 10-12 years understand the power of these John Harbaugh-like qualities each time Don Berwick takes the stage for a keynote talk. Be it his Escape Fire story, or the year he shared his wife’s personal health experience, he was and remains, a consummate storyteller who leads from the heart, knows his calling and inspires all of us to reach a higher level in patient care (see Leadership and Love). His talks elevate others, making everyone in the audience feel as though their work has more meaning after listening to him speak. He is truly one of the multipliers that Darrell Kirch referred to in his keynote at last years AAMC meeting, and as discussed in our recent post, #AAMC12 Calls for New Vision of Leadership. Many safety experts believe high quality, low risk patient care cannot be accomplished unless more leaders possessing these qualities join the healthcare improvement journey.
We have been discussing Lance Secretan, an executive leadership coach who believes it is the following eleven concepts that people are now searching for in those that lead organizations. His philosophy is based on leading from the heart, and his “Higher Ground Leadership” program is based on these concepts. More of his work can be found at: www.secretan.com, and I agree that it is these principles, and the examples set by the John Harbaughs, the Don Berwicks and the Lucian Leapes of the world, that we should strive to emulate when we are given the gift of leading others.
- Leadership. Many of us are yearning for an alternative to business-as-war and leaders-as-warriors. We yearn for spirit in the workplace and for servant-leaders—people who lead with their hearts as well as their heads and wills.
- Values. Business has more opportunity to influence the future than any other institution in the world. New Story Leaders choose to make business an instrument for positive change.
- The End of Competition. The root meaning of ‘compete’ is to strive together—exactly the opposite of its usual meaning. The New Story Leader respects our interdependence—our oneness—and sees how it opens opportunities for growth, both within the organization and out in the marketplace.
- The Cause. People want to work for a Cause that inspires the soul. A Cause acts as a magnet for passion. It articulates the higher purpose of an organization, it describes how we serve.
- The New Customer. The New Story Leader devotes even greater attention to meeting the needs of employees as they do for customers. This goes beyond the usual incentive and reward systems —to practices that awaken passion and satisfy the soul. The result is a dramatic improvement in profitability.
- Integration. The New Story Leader creates an environment in which “work” and “life” are not just “balanced,” but blended into an integrated, seamless whole.
- The Calling. People are looking for more than a paycheck. They seek joy, meaning and fulfillment from their work. A Calling results in work that engages, nourishes and expresses our souls. The leader’s mission is to enable each follower to find, grow and excel in her or his Calling.
- Soulspace. We ask people to contribute to the highest standards of which they are capable while putting them in the dreariest, most uncreative environments in their lives. Imagine the extraordinary work that could flow from sacred workspaces designed to inspire the soul.
- Technology. The Internet, as an example—can be a medium for the web of human consciousness, described by Pierre Teilhard de Chardin as the noosphere. New Story Leaders will reinvent their organizations within this context.
- Learning. The most important ‘fringe benefit’ is no longer healthcare or a pension; it is the right to learn. Learning inoculates against irrelevance and positively feeds the soul.
- Inspiration. The role of the New Story Leader is to inspire others. This ability grows organically from one’s own inspiration.
In an excellent article, Darrell Kirch MD, President of AAMC, recently reminded all practicing physicians of the examples we set, and therefore responsibility we have, to our students when it comes to modeling a culture of respect in medicine. In his September post on the AAMC website, A Word From the President: Building a Culture of Respect, Kirch shares not only his own memory of being disrespected as a student, but also the results of the AAMC 2012 Graduation Questionnaire which shows that 33% of respondents confirm being humiliated by those in a mentoring role. Kirch comments:
When things like this happen, we compromise the learning environments of medical students and residents. Tomorrow’s doctors must be able to learn in a safe and supportive culture that fosters the respectful, compassionate behavior we expect them to show their future patients.
As physician educators, we have an opportunity to shape the culture of medicine. The disservice we do to our profession when we choose to break-down versus build-up our students, and one another for that matter, are missed opportunities to lead and provide a positive role model for those we are enlisted to enlighten. I remember a faculty member at one of the Telluride Summer Camps reinforcing that it’s not just disrespect down the power gradient, but peer-to-peer disrespect that also occurs in medicine. As such, it’s truly going to take educating the young on the “right way” to interact with colleagues, but also re-educating “the old” on tenets of professionalism and the impact disruptive behavior has in creating toxic safety cultures. And it’s going to take all of us to create the change needed and to challenge our peers who believe intimidation is part of the medical education learning culture. As Kirch points out:
As educators and leaders in the medical profession, we have an obligation to eliminate any mistreatment of medical students. The solution starts by addressing the culture and climate at each institution… at UCLA’s David Geffen School of Medicine…implementing stricter policies and faculty workshops were somewhat effective…not sufficient by themselves. What is needed to eradicate medical student mistreatment is, they concluded, “an aggressive, multipronged approach locally at the institution level as well as nationally across institutions.”
In the end, no work environment should include humiliation and bullying. Other industries do not tolerate the disrespect medicine has been willing to accept for many years. Darrell and I have both referred to Dr. Pauline Chen’s piece in the NY Times, The Bullying Culture of Medical School and here on ETY, Bullying In Medicine: Just Say No, about how this negative sub-culture exists during training. Why would we accept this disruptive behavior by a few of our peers in a profession where caring and compassion is at the core of why we chose to pursue it? It’s counter-intuitive and, in the end, always reaches the patient–the person we have sworn to protect. Patients and families see this disruptive and professional behavior and wonder why it exists. Sometimes we have to hit bottom, look in the mirror, and say enough is enough. We need to acknowledge that the disruptive behavior of a small minority of our contemporaries reflects on all caregivers and our profession as a whole. I applaud Dr. Kirch and the AAMC for continuing to bring this unprofessional and unproductive behavior into the open–this is how change begins and care becomes safer for our patients.