Hi everyone:
Some things shouldn’t need saying: Arrive on time. See your patients. Sign your orders and notes. Put patients first, of course.
Still, obvious rules aren’t obvious to everyone. So at this part of the year when we’re creating good habits, let’s be explicit about expectations:
1. Copying and Pasting: My fantasies aside, copying and pasting isn’t going away. As long as Ctrl + C/ Ctrl + V is available, people will use it to save time and track random facts. I do too. But if you copy and paste, you must pledge to accuracy. Delete the distracting detail (”presented with EKG changes, and high troponin” a week after the stent was placed) and crazy contradictions (“check urine culture” followed by “culture negative, stop antibiotics”). Your signature attests the accuracy of your note. Preserve your credibility. Proofread.
2. Document: When you see a patient, write a note. Seniors supervising intern admissions must enter an addendum to document their role (“seen with Dr. X, agree with her findings, assessment, and plan with the following additions, elaborations, and corrections…”). When you see a patient for fever, chest pain, shortness of breath, or a fall, write a note. When you start antibiotics or oxygen, or you transfer a patient to step down, describe what happened. Don’t leave gaps in the record.
3. Call your attending: Attendings are ultimately responsible for your patients, and they depend on you to call them for complications, step ups, unexpected deaths, changes in code status, and premature discharges. Call your attending and document the call (“Dr. Siegel aware”).*
4. Show up: Like any job, you need to show up to all activities, every day, on time. If you’re sick (heaving), have an emergency (kitchen fire), or you’re running late (flat tire), call the chiefs. Required activities include but are not limited to electives, subspecialty clinics, and mandatory teaching conferences: Grand Rounds, 8:30 skill-building sessions, noon conference, YOBM, and Education Half Days. Also, barring urgent patient issues, please respect the speakers and arrive on time, not 5 or 10 minutes into the talk.
5. Be a good citizen: Our community depends on mutual support. Please don’t negotiate when you’re called for jeopardy; the Chiefs are not going to tell you why your colleague is out, just as they wouldn’t tell others about your diarrhea or family crisis. The only correct answer is “yes, I’m on my way.” Also, help each other out: if your colleague is swamped and your work is done, ask how you can help.
6. MedHub: I wish God would give me back the hours I’ve wasted nudging people to log work hours and complete evaluations. Just do them, without delay. MedHub information is essential and mandated by the ACGME.
7. Clinic Inbox: Your inbox is the repository of test results, key communications, prescription requests, and time-sensitive tasks. Your patients depend on you to respond promptly to these messages. Aim for inbox zero.
8. Be Civil: There is nothing to gain by raising your voice, venting, swearing, or thinking ill of others. Almost everyone around you—colleagues, staff, patients—are doing their best to navigate the stressful world of healthcare. Smiles, encouragement, and patience are priceless.
9. Speak Up: If you see a problem, say something. The first step to fixing a problem is naming it. Is the call room dusty? Tell us. Can conferences be better? Tell us what would work. Do you want more procedural experience? We’re on it (Dr. Bazan’s project). Speak up at program directors meetings, which beats posting anonymous questions, which preclude discussion and risk misunderstanding. Join a committee. Drop an email. Extra credit for suggesting solutions.
10. Take Care of Yourselves: You can’t thrive at work, let alone live a good life, if you don’t take care of yourselves. Too many of us sacrifice self-care (me too). Please eat, sleep, exercise, and socialize. So many problems take care of themselves when you take care of yourselves.
This list is by necessity incomplete, but you get the point. Most of you already know how important these expectations are. Doing the right thing is at the heart of professionalism, a thriving residency, and flourishing residents.
Enjoy your Sunday, everyone. I’ll be headed to the beach today for an afternoon of sunshine and reading,
Mark
*“…and he said I was brilliant.”
P.S. What I’m reading and listening to:
The Spinoza Problem By Irvin D. Yalom
Yale Trad Edu Pods (courtesy Aaron Eisman)
Why Calling RFK Jr. ‘Anti-Science’ Misses the Point By Rachael Bedard
Musk’s Chatbot Started Spouting Nazi Propaganda. That’s Not the Scariest Part. Zeynep Tufekci
The Sunday Morning Post: What Was It Like to Live in 1776? By Derek Thompson
This Law Made Me Ashamed of My Country By Lawrence H. Summers
P.P. S. Yesterday, we had a family chocolate chip ice cream contest, conducting a blind taste test comparing six of Connecticut’s most renowned brands. Guess which ice cream won…
Stay tuned for next week, when the winner will be announced…
MDS