I am a regular doctor. My job is to take care of people.
I see, ablate, and operate on patients every day.
I work in the real world, outside of an academic institution or think tank. Sadly, I do not have a foundation.
Like most doctors, I take pride in my work. No quality assurance person is harder on me than myself. I hang a lot of my self-worth on my skills as a doctor.
But I have my own kryptonite: farcical things that in the name of quality improvements, or controlling costs, or enhancing equity actually impair patient care. Here are a few examples:
- Protocols for everything.
- Mindlessly thinking that guidelines apply to all patients and that spreadsheets or checklists can measure quality.
- That it takes longer to do the paperwork for a procedure than the procedure itself.
- That my note to a referring doctor, which should be a chance to tell an interesting story, has devolved to an invoice that proves I am not over-charging someone.
- That much of healthcare policy emanates from think tanks, academics and politicians rather than real-world doctors. (I realize that this is partly my fault.)
In writing on doctoring, healthcare policy issues come up frequently. When they do, I label them Health Care, or Health Care Reform. A few months ago, I dreamed that I was the surgeon general, and had a plan to solve our obesity crises.