How much is a $10 bill worth?

I really couldn’t have asked for a better start to our time in Telluride. The surroundings are beautiful, the accommodations are luxurious, and above all, the people are simply outstanding. Everyone from the students to our gracious hosts at TSRC to the organizing faculty have such a great energy. I’m so excited to get to spend 4 days away from all of our other obligations and just immersed in discussions and learning about patient safety.

There’s nothing to drive home a lesson like a poor financial decision and a little bit of embarrassment. I learned that well on day 1. When Paul said he was going to auction off a $10 bill, my immediate reaction was “I want nothing to do with that. If this is an activity that he’s doing in a session on negotiation, there’s just no way for me to win.” The auctioning began, and I intended to stay out. I was trying to think quickly about what could happen, and made the (incorrect) assumption, that I just had to be the guy to say $10, because nobody would really pay $11 for a $10 bill would they? The room was silent for a moment after the $5 bid, so I quickly counted it out, and discovered I could take $6, $8 and then $10. I’m not sure how I thought paying $10 for a $10 bill would benefit me, and maybe it was the altitude, but I soon found myself saying “$6!” Sam and I began bidding back and forth, and after $8 I realized what I’d gotten myself into. When I said $10, he would be down $9, so he would rather pay $11 for a $10 bill than just lose $9. So then I stopped right? Wrong. We carried on until Sam said $15, when we looked at each other, and despite Paul’s criticism of our manhood, decided this needed to stop sooner rather than later. We struck a deal to split the losses, and Paul was gracious enough to give us his newest book on how to negotiate your first job.

I took many lessons away from this poor business venture:
1. If it seems like a strange deal, and your gut says to stay away, don’t try to beat it, just stay away.
2. Once you realize defeat, just stop. (Be conscious of your ego). I realized early on that somebody had to lose, but didn’t want that to be me. My ego got in the way of my common sense, and it cost me $14.
3. Don’t allow the frantic pace of a situation to overwhelm you into making irrational decisions. Had Sam and I slowed down to discuss our options rather than carrying on our bids, we could have beat Paul before I even said $6.

How does this relate to patient safety? I have seen too often in the hospital environment, where lessons 2 and 3 could have prevented unnecessary stress or harm to a patient. The constant pressure to see more patients, do more procedures, and generally be more “efficient” with our time often causes us to jump too quickly to a diagnosis (premature closure). Once we’ve jumped to a diagnosis, and confidently shared it with others, we are too prone to cling to it beyond rationality. Our ego gets in the way of us re-evaluating, asking what we may have missed, and being open to different opinions. All of these things are detrimental to the health of our patients.

My net losses came to $10, as Sam was kind enough to stop me later in the afternoon with $4, netting us both a loss of $10. All in all, I can honestly say that I would happily pay $10 (or $14) for these lessons. I’m excited to see what the rest of the week has in store for us here in Telluride!