Loathe is Such An Unseemly Term

By  |  November 12, 2018 | 

I do not loathe him, actually. As you might have heard, Atul Gawande will be running the big health concern comprised of Amazon, JP Morgan, and Berkshire Hathaway.

How in heavens name he was able to pump out another tome in The New Yorker, a sharp one at that, boggles my mind.

If you do not know who Atul Gawande is (shame on you), he is the preeminent essayist writing on healthcare today—and typically he publishes books, pieces in The NYer, and original research in NEJM, JAMA, etc., almost ceaselessly. He is a policy wonk, advocate, documentarian, and yes, an active head and neck surgeon at Harvard. Disgusting.

 Like great acting or another expressive art form, when you read a well-crafted piece of writing, you do not realize how skillful it is until you bury yourself in the storyline and let it soak a bit. It’s making the incredibly complex, sometimes mundane, and what most folks might perceive as “non-relevant” to their lives, otherwise stirring and central.

Again, you don’t perceive you are pulled into Gawande’s orbit, however, until you finish his narratives and appreciate what it is he is trying to convey. Laborers and brain surgeons benefit alike and would find his work equally potent–and in that alone, his gift is extraordinary. As proof, check out how he weaves one of his surgical encounters in the closing pages of the essay and expands the theme he began with to make the whole of his message greater than the sum of its parts.

This go around he profiles Harvard’s foray into its EPIC upgrade and what EMRs mean to docs (sound familiar?). You think it’s a thud of a topic, eh? Just begin the piece. You will see.

And here is a primer to whet your whistle:

Why Doctors Hate Their Computers

Digitization promises to make medical care easier and more efficient. But are screens coming between doctors and patients?

On a sunny afternoon in May, 2015, I joined a dozen other surgeons at a downtown Boston office building to begin sixteen hours of mandatory computer training. We sat in three rows, each of us parked behind a desktop computer. In one month, our daily routines would come to depend upon mastery of Epic, the new medical software system on the screens in front of us. The upgrade from our home-built software would cost the hospital system where we worked, Partners HealthCare, a staggering $1.6 billion, but it aimed to keep us technologically up to date.

And this:

“Sadoughi told me of her own struggles—including a daily battle with her Epic “In Basket,” which had become, she said, clogged to the point of dysfunction. There are messages from patients, messages containing lab and radiology results, messages from colleagues, messages from administrators, automated messages about not responding to previous messages. “All the letters that come from the subspecialists, I can’t read ninety percent of them. So I glance at the patient’s name, and, if it’s someone that I was worried about, I’ll read that,” she said. The rest she deletes, unread. “If it’s just a routine follow-up with an endocrinologist, I hope to God that if there was something going on that they needed my attention on, they would send me an e-mail.” In short, she hopes they’ll try to reach her at yet another inbox.”

Now download the pdf or fire up the printer.  No excuses. Put the Netflix aside for half hour tonight and feed your brain. You will thank me in the AM.

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About the Author: Brad Flansbaum

Brad Flansbaum
Bradley Flansbaum, DO, MPH, MHM works for Geisinger Health System in Danville, PA in both the divisions of hospital medicine and population health. He began working as a hospitalist in 1996, at the inception of the hospital medicine movement. He is a founding member of the Society of Hospital Medicine and served as a board member and officer. He speaks nationally in promoting hospital medicine and has presented at many statewide meetings and conferences. He is also actively involved in house staff education. Currently, he serves on the SHM Public Policy Committee and has an interest in payment policy, healthcare market competition, health disparities, cost-effectiveness analysis, and pain and palliative care. He is SHM’s delegate for the AMA House of Delegates. Dr. Flansbaum received his undergraduate degree from Union College in Schenectady, NY and attended medical school at the New York College of Osteopathic Medicine. He completed his residency and chief residency in Internal Medicine at Long Island Jewish Medical Center in New York. He received his M.P.H. in Health Policy and Management at Columbia University. He is a political junky, and loves to cook, stay fit, read non-fiction, listen to many genres of music, and is a resident of Danville, PA.

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