Day 1 & 2 Reflections: The silent & non-transparent culture

The past two days have been an eye-opening and challenging experience. Going into the second year of my medical school education, I looked to my future training years with a cheery optimism. While I recognized the various challenges in the delivery of quality and safe care in American hospitals, I lacked clarity on the complexity of this issue. For one, patient safety is often compromised because an individual’s negligence can slip through a culture that fosters silence and not enough transparency. As trainees recognize medically inappropriate procedures, it takes both courage and skill to speak up and intervene on the patient’s behalf. As health providers caring for patients, it takes a patient-centered perspective to go beyond consenting a procedure for liability waiver, and really advocate for patients through open and thorough discussions of their care.

Much like patients stuck on an island of suffering and helplessness, we the providers are often stuck in our own worlds too. Challenging an attending physician puts that letter of recommendation that we need at risk. Talking to that “difficult” patient and family about their treatment again for the third time in a week will be mentally exhausting especially after a long day at the hospital. In essence, when we put our own self-interests before those of patients, it’s much easier to adopt an attitude of say nothing and do nothing when we see potential risks. It’s much easier to finish that patient encounter with just enough information to proceed with the treatment plan, instead of having an extended conversation with the patient and family about risks, benefits, and alternatives of their care. Unfortunately, medicine practiced without considering the patient leads to dire consequences that the patients and families must face, sometimes for the rest of their lives.

Telluride has certainly reminded me again why I want to pursue medicine. My goal is to care for and heal people, not to take the path of least resistance by avoiding difficult conversations and situations or jumping to quick diagnostic conclusions. The conversations here with peers and colleagues have also reassured and reaffirmed my faith in medicine—that we are a group of people who will put patients first and will do everything we can to advocate and protect, by challenging not only ourselves but the healthcare system. And even when we make mistakes as imperfect human beings, we will celebrate open reflections and aspire to be the agents of change for our generation.