Tom Peters inspired me this with The Speed Trap: When Taking Your Time (Really) Matters. So much of his thinking in management can be translated to medicine. So it got me thinking …what are the things in medicine that should be methodical? What should be done slowly?
To the uniformed reader, the answer will seem obvious: everything.
But in medicine there is fast and slow thinking. And if we did everything slowly there’d be no time for anything. The medical day is a zero-sum situation. Time is limited so we have to make difficult decisions.
Here are a few things that should be done slowly:
Impressions
For consultants, nothing in the consult report is as important as what you think. For me this is something I have to remind myself of every day.
Prescriptions
This should be obvious. Measure twice, cut once.
Thinking when things don’t make sense
When things don’t make sense either your data or your thinking is wrong. Understanding which is which isn’t a quickie.
Critical conversations
Not every conversation in medicine is critical. I can say that as a surrogate for two parents who died after long bouts with chronic disease. There was a time for quick doctor visits and times for serious sit downs. When we conflate them there are problems.
Reviews with students and staff
Medicine moves fast enough as it is. The time when we’re forced to reflect and review and advise should be slow and methodical.
Time out
Time out is the pre-op process of confirming what we are doing and what we may be concerned about. Knowing that the patient, procedure and laterality is spot on is always a good place to start.
Methodical where it’s clearly needed
Throughout the day we find things that must be done methodically. When I used to round on the largest GI service in the U.S. our inpatient service was huge. I would tell the fellow that we should spend as much time as every parent needs. The translation is that we should spend our time where it’s needed and not where it’s not.
What else in medicine should be done slowly?
If you like this post you’ll probably enjoy the 33 charts Slow Medicine Archives. This collection of writing covers issues related to methodical pace and flow in medicine. As medicine becomes increasingly industrialized, this conversation will become more critical.
Image via Rawpixel on Unsplash. Slightly modified.