“Just the way it is…”

The other day, I had an interesting conversation with one of our Telluride colleagues. The topic of our discussion was the “business of medicine,” but somewhere in our talk we started to realize something very unique to the practice of medicine. If the field of medicine is “just another example of a service industry,” as some proclaim, then why do we consistently fail to uphold the standards of excellent customer service?

Why are we okay with autrocious rates of mortality associated with sepsis? How do we still allow impaired medical providers to perform the most delicate task of serving others? Why are we consistently allowing the same human mistakes to occur and harm our patients? We talked a lot about the parallels of the airline industry to medicine, and while the model of safe practice has been nearly perfected in aviation, we are still trying to understand and apply what works within medicine. I also think of what happens when a flight is either delayed or cancelled, and the measures the airline companies take to rectify and maintain the trust and business of their customers. If, in the most superficial way, we are going to treat our patients as “customers”, then why is it okay to make them wait months for doctor’s appointments? Why do we lack transparency when errors are made and harm has occurred? Most of all, why do we allow the compromise of our patient’s safety to go unnoticed, unaddressed, and in some ways dismissed as “human error”? The unnacceptable answer I have received far too often is nothing more than “dogma”. I immediately flash back to those moments where the answers to my inquisitive mind were “that’s the way it’s been and that’s the way it will always be”. Am I supposed to accept these words as an answer, a valid justification, for why my patient has just suffered?

After spending some time at the Telluride Experience, I am noticing a change in my thought process, and if there’s one thing I can challenge everyone here with this week, it is to never accept this “dogma” as the final answer, or the only truth, to your intricate questions. Also, I hope that wherever we are, we can develop and expand our practice of medicine to be truly exceptional, and inclusive of that mindfulness of not only our patients, but also of ourselves.