What’s The End Goal?

As of this evening, we have one full days worth of Telluride curriculum under our belts. I have already come to appreciate the various backgrounds of other members of our group; it contains medical students, nurses, nurses working towards advanced degrees, Ph.D candidates, podiatry students, residents, physicians, and more. If one thing is abundantly clear through conversations with this group, it is that everyone is committed to the best possible patient outcomes! No one here has worked as hard as they have to get to this point in their education or career to provide anything less than perfect medicine. That being said, our medical system consistently provides less than perfect medical care. While the field of medicine is inherently more complex than aviation, the gravity of the broader medical culture’s acceptance of breakdowns in care and resulting adverse events is overwhelming to think about in the terms of aviation. Today we were shown a graphic which depicted all of the flights in a 24 hour period in the entire world. 93,000 flights take off, travel, and land each and every day, with extremely minimal adverse events causing passenger harm. In thinking about medicine as an entire entity accepting anything greater than zero medical errors can be reasonably compared to an airline accepting one flight crashing in any given time span. That sounds absolutely crazy to me! In that same vein, accepting any degree of medical error without consistently working to bring that number down is becoming equally crazy through the training I am receiving here in Napa valley.  While accomplishing true zero adverse events in medicine seems impossible, we must not stop the attempt.

Too many things can get in the way of providing our best possible version of care. If there’s one thing I learned today, it’s that we would be fools to claim that we really want to help our patients if we allow any known barrier to providing them the best possible care to still stand. Some of these barriers include hierarchy of power structure which limits inter professional communication, preference based medicine–as opposed to evidence based medicine–which allows physicians to use any method of providing care they desire despite having known best practices, and maintaining a deeply ingrained culture of autonomy, self-reliance, and shame for mistakes. If we truly analyze these factors alone, we quickly realize that each of these is a hindrance from providing the best possible care to patients! If we truly desire to serve our patients to the best of our ability, we need to chip away at these barriers each and every day, and remember that our end goal is always the health of the patients we serve.