Goodhart’s law suggests that when a measure becomes a target, it ceases to be a good measure. When I first read this I couldn’t help but think of healthcare and the quest for the perfect patient satisfaction score. The problem is that as soon as we steer physician behavior and teach to the test, patient satisfaction scores stop being a valid measure. Essentially, ... Continue Reading about Goodhart’s law and patient satisfaction
The Opposite Problem of the Clinic No-Show
Modern clinics are obsessed with the no-show. This is the clinic patient who makes an appointment but never arrives. Clinics spend a tremendous amount of time trying to solve the no-show. They begin with operational strategy sessions. Then they call, ping, and survey the no-show. Because in a fee-for-service model in a high demand specialty, the no-show is a ... Continue Reading about The Opposite Problem of the Clinic No-Show
The Power of Kindness: 4 Reasons to Read the Book
Dr. Brian Goldman of entered The Exam Room recently to discuss his new book, The Power of Kindness, Why Empathy is Essential in Everyday Life. Dr. Goldman is an ER physician and medical journalist. He’s the host of Canada's CBC Radio One White Coat, Black Art. As he describes, he has made a successful career pulling back the curtain on the world of medicine by getting ... Continue Reading about The Power of Kindness: 4 Reasons to Read the Book
Tell Me What You Understand: My First Question for Hospitalized Patients
This is my first question for hospitalized patients: Tell me what you understand. Let me explain. I’m a pediatric specialist. I help hospitalists and pediatricians care for children. Actually, I’m typically one of several providers helping families care for a medically complex children in the hospital. And for better or worse communication can sometimes be ... Continue Reading about Tell Me What You Understand: My First Question for Hospitalized Patients
Overutilization and Clinical Exhibitionism
This brief essay from the British Medical Journal is worth thinking about. Here’s the quote about overutilization that pulled me in: There is a hidden curriculum in medicine that encourages trainees to do extensive workups to demonstrate their knowledge and curiosity. As a resident I rotated through one consult service where I was encouraged to strive for 10 ... Continue Reading about Overutilization and Clinical Exhibitionism
Your Big Day | Conveying Empathy in a Greeting
Not long ago I went to my dentist for a major bit of dental work. When my dentist greeted me chair side she remarked, “So this is your big day.” And it was actually. A problem that had been an issue for some weeks was coming to a resolution. We chatted for a bit and she got to work. This idea of recognizing the magnitude of my visit stuck with me. It was ... Continue Reading about Your Big Day | Conveying Empathy in a Greeting