Telluride Reflections-Day 3-Kirsten Midgley

The last couple days have been wonderful. They have been engaging, exciting, jam-packed, but truly thought provoking. One of the activities that has stuck with me most thus far is the video that we watched today about Michael. Videos such as these effectively remind me of my naivety; terrible things happen to good people everyday and most often these terrible things can be prevented. Michael’s story was most moving for me because of the misrepresentation and miscommunication of information about his surgery in the first place. This made me realize how fortunate I have been to have physicians, even in a primary care setting, explicitly inform me of procedures that he/she wishes to do and why. I feel so much more aware of the elementary but crucial information that can sometimes be overlooked by the physician in their communicating with a patient. In order to foster a more safe patient environment, effective communication is the cornerstone. To ensure that communication is effective, in this case, aspects such as benefits and risks must be made aware to a patient for all parties involved to make the safest decision for the well being of the patient as a team.


One Response to Telluride Reflections-Day 3-Kirsten Midgley

  1. jbsfsu says:

    Thanks for the great post. That video was pretty good at highlighting a lot of shortcomings and barriers in medicine. You mention that you said about having physicians in a primary care setting utilizing clear and effective communication to relay information about procedures to you. One sad thing about the video that we didn’t really have time to discuss was the doctor on doctor hate that occurred in this scenario, when the family practice doctor faxed the family a letter saying essentially “the procedure is not needed” only to have the neurosurgeon say “what do they know? They are only a family doctor.” I think that kind of discord is toxic to a health care team and in this instance proved to be a huge issue. The patients may begin to mistrust a physician, patient care dialogue is effectively shut down between the two physicians, and coordination of care is severely limited. I think there are plenty of other examples of doctor on doctor hate that has a similar effect on patient safety. On one hand, part of being in primary care is understanding that you have to rely on the expertise of your consulting specialists on cases that you may be unfamiliar with. That being said, I feel in the in this case the family physician’s concern, if addressed appropriately by the neurosurgeon, would have prompted a second opinion and may have likely changed the outcome. We as future physicians have to understand that regardless of what field we go in to, we are going to be part of an integrated team hopefully with all different types of physicians from all different stages in their career. You cannot discount the expertise that comes from experience. Maybe the family physician was never formally trained on all of the implications and nuances of colloid cysts like the neurosurgeon, but (and I’m assuming here) maybe the physician had some previous patient experience with this type of issue and was therefore able to draw from that experience to voice his thoughts on the issue to the family.
    You’re really fortunate to have had physicians that are so clear in their transmission of information. Like someone said in class, we are unprepared for shared decision making at this time so hopefully you’ll be able to reflect on those experiences that you were thinking about for this post when it comes time for you to have informed consent discussions. What was it that you think the physicians did particularly well?

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