Telluride East Reflections

I really enjoyed the negotiation exercises we had today. It was interesting to see the concept of negotiation broken down into such small pieces. The results of the Hamilton Estate case were intriguing. I managed to settle on buying the property for $45M, which I thought is a pretty good price. It was $15M less than my best alternative. Yes, it was slightly above the maximum value of the property today, but not too much. I thought I negotiated well and that I got a great deal; I am happy with it. It turns out though that that price is actually at just about the average at which the property was sold across the entire group. I was really surprised to hear that one person bought the property at $31.5M – that’s well below the best alternative option of the seller! I am not sure if it was because the seller did not understand the assignment or if the buyer proved that there is another value for the property that’s not reflected in the purchase price. Either way, this emphasizes the fact that negotiation has two sides – the buyer and the seller, and the result of the negotiation is the intricate sum of the interaction of the two.

I was discussing interprofessional interactions and the tribal nature of caregivers in the clinic with some of my colleagues. It occurred to me that we really do not teach healthcare students how to work in an interprofessional team. Medical education is divided into two parts: the classroom and the clinic. The first two years are dedicated to the classroom while the last two years are in the clinic. While in the classroom, we are forewarned that medicine can be “tribal” and that we should reach out and work with the nurses, pharmacists, etc. when we get to the clinic. “When we get to the clinic”. It is sort of a funny phrase when you talk about doing things differently. The clinic is full of inertia anchoring its members into doing things the way they have always done it. We are not taught in the clinic how to effectively work with other professions, we are taught in the clinic how to work other professions the way it has always been done. Thus, teaching medical students about proper interprofessional work in the classroom without reinforcement in the clinic is most likely to be largely futile. The students will only be able to make a true difference at least once they become residents; that is, if they still recognize that it is an important aspect of being a caregiver. Although I believe interprofessional training must begin in school, the real change must be made in the clinic – the culture must change. Again, it seems like such a daunting task. It is. But it is events such as this Telluride East Summer Camp that give me hope that it is not an impossible task, that it is just a reality that’s some years away.