Sunday, July 15, 2012

Meaningful Abuse

Undoubtedly the most difficult challenge of practicing medicine is the complexity.  There are both elements of IQ as well as EQ.  Because of this, the process of training is marked by a number of hurdles and weeding out periods.  Only a certain number of people pass the premed curriculum.  Those who succeed can get tripped up on MCAT testing.  If ones score are acceptable, so begins the interview process.

Those lucky enough to matriculate into medical school are pushed on every level.  Hours of classes and studying are followed by repeated skills assessments in which a certain percentage always fails.  The clinical years are marked by grueling physical and mental endurance.  The harsh realities of sickness and death, as well as the intense pressure cause not an insubstantial number of students to drop out.

And of course, once the weary student actually graduates, they get plunked on the head by residency.  When a patient enters the office of an attending physician, they step into the workshop of one whose abilities have repeatedly been stretched to the breaking point.  Yet still, few who inhabit the exam room would be called true masters.  In medicine, mastery and perfection are unreachable ideals.

This is why so many of our best and brightest enter the field.  It is like food to the hungry, water to the desert.

So it would take a truly twisted soul to suggest that what's needed in modern day medicine is more complexity.  Somehow, however, this is exactly what the government and reformers are suggesting.

Instead of searching through computer screens, we should be looking people in the eye.

Instead of trying to remember meaningful use criteria, we should be thinking deeply about our patients.

We are taking infinitely complex processes and adding new layers.  We are wasting our scarce resource, brain power, on paper work.  Our numbers may look great, but care is suffering.

That's the funny thing about the term "meaningful".

Perspective is everything.

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