“I’m a little obnoxious sometimes,” claimed Dan Ford this afternoon discussing his fervent advocacy of root cause analyses in response to sentinel events. Earlier that morning, Mandy too had confessed to being “that annoying nurse” who unabashedly telephones on-call residents when a concern arises. These champions of patient safety proudly own these deprecatory adjectives like “obnoxious” and “annoying” because they know that their actions are challenging the status quo for the betterment of patient care.

It is my hope that all of us, students and professionals alike, emerge from this week in Telluride a bit more enthusiastic about being obnoxious. To be “obnoxious” in this context is to put our patients’ needs first in spite of a bruised ego. We “annoy” despite the fear of openly defying the medical culture’s norms, and we “irritate” others because we have the courage to understand that it will take assertive individuals to lead the change that we want need to see.

I worry that many of us, within the safe embrace of the Rocky Mountains, can stand up and avow a career of advocacy for patient safety, transparency, and high reliability, but as we return to our respective institutions how many of us will succumb to the communities of fear that predominate our healthcare systems? How many of us just having completed the first year of medical school will have the fortitude to speak up to a resident during clinical rotations as a third year medical student? We will all undoubtedly encounter scenarios that challenge our commitment to patient safety. It is my expectation that, in these impending moments of contention, we remember Lewis Blackman’s story as a victim of preventable medical errors, and preach the merits of patient safety measures. I expect us to hold strong to what we know is necessary to prevent sentinel events despite it being contrary to the antiquated yet entrenched status quo.

Our egos should be attached to the idea of being the annoying physician, nurse, pharmacist, medical student, etc. We should be displeased with a presence that doesn’t foster communication and teamwork within a care-team. Standing out as an advocate and pioneer for patient safety should be the ideal. It should be our goal to be obnoxious.