A Time to Renew and Expand Our Sense of Professionalism
Mar21

A Time to Renew and Expand Our Sense of Professionalism

Retirement is a time of reflection. Most of one’s agency lies in the past. I must organize opportunities to transfer bits of experience, insight and wisdom to those who still do the work if I am to have the joy of continuing to contribute to the dream of a future where we enjoy   …Care better than we’ve seen, health better than we’ve ever known, cost we can afford,…for every person, every time…in settings that support...

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D. F. Wallace, Burnout, and Healthcare
Aug26

D. F. Wallace, Burnout, and Healthcare

What does David Foster Wallace have to tell us about burnout? More than most healthcare professionals might think. The publicity for The End of the Tour, a new film starring Jason Segel as Wallace, has reminded me of the message I took away from the first Wallace book I ever read, This Is Water: Some Thoughts, Delivered on a Significant Occasion, about Living a Compassionate Life (2009). Before 2009 I had missed out on David Foster...

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The Moral Injury of Avoidable Death
Jun25

The Moral Injury of Avoidable Death

Last week I passed on a story my friend Dr. Doug Beers told me about a case of avoidable death as a result of medical “overkill.” It was a distressing story, but Doug recently told me another story that disturbed me more. We were sitting on the dock at my place on Little Lake Sunapee, chatting with my neighbor who had just given us a tour of the lake on his boat. The conversation turned to my long-term friendship with Doug, and to the...

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Overkill Can Be Deadly
Jun18

Overkill Can Be Deadly

Dr. Doug Beer, my former colleague and longtime friend, told me a story about the way healthcare overkill can actually kill a patient. Doug, who practices internal medicine at Emanuel Hospital in Portland, Oregon, and I were talking about cancer treatment during a recent visit he and his wife, Leslie, paid to my wife Nancy and me in New Hampshire. Doug confused me when he said he had a patient who died because he was treated too soon...

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Joys and Sorrows of Healthcare Professionals
Jun12

Joys and Sorrows of Healthcare Professionals

Healthcare professionals find both joy and sorrow in their work. Many of us carry scars. I think it helps to tell the stories we carry with us from our experiences in the present system, even when they are not feel-good stories. It gives us ways to think about transforming healthcare delivery for the future. Recently I had the pleasure of some long conversations reflecting on the healthcare system with my former colleague and friend...

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Everyone Gains from Lean
Jun05

Everyone Gains from Lean

Everyone, whether they are senior management, middle management, line management or the hands-on employee has much to gain from Lean. Lean can buffer the impact of chronic issues of emotional fatigue and performance pressure. It also helps with the stress of accountability in the face of difficult external and internal factors and and unrealized personal aspirations. Lean can combat the cynicism that arises from the pettiness of...

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Fostering Healthcare Innovation in Vermont
May05

Fostering Healthcare Innovation in Vermont

In my recent encounters with leaders who are fostering healthcare innovation in Vermont, I have observed that leadership within the ACOs, The Vermont Medical Society, forward-looking and socially oriented members of Faculty at the UVM Medical School, the leadership of state health agencies, members of the legislature, the governor and the local leadership of the regional health areas all have a high degree of understanding of the...

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Lean Can Address Burnout?
Mar10

Lean Can Address Burnout?

Why is it that the discussion of Lean so rarely becomes a discussion of how Lean can address the issues of burnout while reducing waste and improving value for patients? If Lean were presented with a more robust description and elucidation of its mechanisms that enhance the experience of everyone in the enterprise as a counter to the burnout that is so prevalent in healthcare, could it be possible that more executives and boards would...

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