“I trust that you recall, Julie, our mention of a physician’s paradigm (the window through they see the world) a week or so ago. I personally feel that a physician at the end of residency is better prepared to practice his profession than one at the end of training in law, science, theology, or whatever. Physicians probably also feel that way, and that may be the source of their paradigm. We know, however, that there is a lot more for them to learn, and the body of essential knowledge is expanding every day.”
“That’s for sure, Curmudge. Doc Mack has said that four years seems too short for medical school. And it seems as if everyone is suggesting that their favorite topic ‘ought to be taught in medical school,’ everything from nutrition to sociology to data management. Even the Medical College Admissions Test (MCAT) is being expanded to include ‘critical thinking and the sociocultural and behavioral determinants of health.’ O course, you and I know that those who write about Lean and patient safety want future docs to learn more about collaborative teams and standardized work. I certainly don’t envy anyone on a medical school’s curriculum committee.”
"As an outsider, it seems to me that medical school is not entirely free of wasted time. It may just be tradition and a rite of passage, but docs-to-be spend time and effort learning the language of medicine…words like febrile and syncope. Why not just use ‘fever’ and ‘faint’?”
“It’s like our use of Japanese words in Lean, but we use only a half-dozen of them. I think we’ll have to conclude that Lean, with all of its applications in efficiency, quality, and patient safety, will not be taught formally in medical school. But what about teaching teamwork during residency?”
“Julie, a lot of people feel that time spent in residency is already too short, especially with the new 80-hour per week work limit. The limit keeps residents from fully managing a patient’s continuity of care. And I certainly wouldn’t want a surgeon fresh out of residency operating on me without having lots of experience with the procedure.”
“Let’s face it Curmudge; Lean training for physicians will have to be an informal, ad hoc undertaking.”
“Well, not entirely informal. Physicians can earn CME (continuing medical education) credit by taking a course offered by a provider accredited by the Accreditation Council for Continuing Medical Education. Lean Overview, offered by the Kaizen Promotion Office at Affinity Health System, is such a course.”
“Great! Now we need to find ways of encouraging physicians to attend. Perhaps we can document ways by which Lean touches a physician’s two most common hot buttons, better outcomes for patients and a less harried personal life for the doc. Can we do that in later postings?”
“I hope so, Julie. Additional encouragement should also emanate from the organization. Physicians listen best to other physicians. Physician leaders can stress that course attendance is time well spent.”
“Hey, Curmudge, these approaches sound like winners. Let’s do it.”
“Before we take the weekend off, Julie, here’s something hot off the web. Eastern Virginia Medical School is requiring for graduation that their students complete the IHI (Institute for Healthcare Improvement) Open School Basic Certificate. It includes online courses in Quality Improvement, Patient Safety, Leadership, Patient- and Family-Centered Care, and Managing Health Care Operations.”
“Wow! That should give the students something to do in their spare time.”
Kaizen Curmudgeon
No comments:
Post a Comment