Archive - July 2015

Medical Malmeasurement
Amazing Grace Sung With Us Rather Than At Us

Medical Malmeasurement

Credit Thomas Barwick/Getty Images

Credit Thomas Barwick/Getty Images

Malmeasurement is my word for when organizations use the wrong measures. I’ve written about it before, for instance, here.

The crux of the idea is that by using the wrong measures, organizations automatically get off track because the results are meaningless.

Last week I was talking to a doctor, an internist. She said that her practice, like most around the country, have stopped doing rounds at hospitals. They are kept abreast of their patience progress by hospitals, but have separate realms.

I was horrified by this. Your internist is your regular doctor, the one who actually knows you as a healthy person, and may have years of experience treating you. And they are not primarily involved in your care when you are hospitalized.

“Does it work?” I asked her.

“It works great,” she said, “We all have access to the same information and the specialists do what they do best.”

And then she continued.

“Of course, the patients hate it.”

Ah, now we’ve moved from malmeasurement to matterness (and, yes, I do like making up words!)

The reason for the change in who cares for patients in hospitals is explained in a blog post by a doctor. He writes, “…primary care physicals can maintain a busy outpatient practice without the burden of having to round on patients while they are admitted.”

We patients are seen as a “burden.” Hmm, funny way to create a health care system. In a revolving door health care industry, I imagine that there are people who ambivalent about seeing an internist with whom they may not feel any connection.

But for other people, like me, who take a great deal of care in choosing their physicians, and want desperately to think that they have built a relationship with someone who has seen them in a paper gown year after year, the idea that any doctor will do just won’t do.

We patients matter. translations Doctors and hospitals that want to pretend that streamlining and efficiency are the best measures to use for health care are simply wrong. The first and primary measure that should be used is: do patients feel cared for in our system?


Amazing Grace Sung With Us Rather Than At Us

I hope you didn’t miss the extraordinary eulogy the President gave a few weeks ago in the wake of the abhorrent massacre at the Emanuel African Methodist Episcopal Church in downtown Charleston, SC. Nine people were killed while in Bible study class with only hatred as a flimsy rationale by the shooter, Dylan Roof.

The eulogy was both personal and profoundly universal, with the president talking about the power of Grace, of basking in the glory of a power larger than ourselves that enables to forgive and provide solace to others. And, as you well know, he sang the historic hymn of Amazing Grace, as proud as it was imperfect. Here, watch (better, watch the whole speech):

Donovan X. Ramsey wrote a thoughtful essay about the President’s eulogy entitled, “President Obama: Talk to Black America Not At Us.” Ramsey captures the feeling that many people had watching the speech that this was the President we have been waiting for. Not the timid one, or the Professor in Chief, or the worn down president with a small “p” who never really wanted a battle with the opposing party. This was the one that we have seen in such brief moments; in mid-2007 when he invited people to shape his campaign with him rather than just write checks like the second campaign. This was the hope: that we would all participate equally, passionately in shaping this presidency.

Unfortunately, more often, the President and his team hid behind closed doors, wrote code for a disasterous health care site done by bureaucrats when an army of open-source coders stood ready to help. Backed down from open town hall meetings with pro-marijuana activists refused to be overlooked.

Part of what made this eulogy so powerful was how infrequently we have seen this President. The one who is with us, a part of us, not working and talking at us. This is also the essence of leading with a Matterness lens. No one is waiting out there for some leader to give them marching orders. chinese to hmong We are ready, willing and able to jump to action, when we are asked to participate in meaningful ways.

Ah, well, the Obama years are almost over. Maybe, someday, we’ll get a leader who stops working at us.


Copyright © 2018 Allison Fine