Clinical

The Science Behind Crazy O.R. Rituals

Everybody has them.  If you think you’re an exception, ask your PA, scrub or circulator and get ready to be surprised.  I’m talking about bizarre little rituals in the operating room.  They’re usually innocuous, arbitrary habits, but if neglected, make the entire case feel “off”.  Maybe you always have to be the one to clip the tourniquet towel; maybe it’s…
Career Path

What is the purpose of retirement?

Many doctors are increasingly frustrated about the bureaucratic and regulatory environment of physician practice. For those who are nearing retirement age, it is tempting to “hang it up” early to escape the stress of a job that has lost its fun. Since younger physicians are frequently much more adept at the use of EHR’s and other forms of technology, they…
Community

How can we move the needle on an under-performing team?

Over the past several years I have actively cultivated my appreciation of what interferes with optimal team performance, and spent a considerable amount of time investigating possible solutions. I had the privilege recently to lead a workshop on team development with the Wake Forest Orthopaedic residents, and it became very clear to me that encountering conflict on teams during the…
Community

Conflict on your Team: Dismissed, Deplored or Discussed?

I attended the annual meeting of Team STEPPS in Cleveland in June. STEPPS stands for Strategies and Tools to Enhance Performance and Patient Safety. The initiative has been developed by the Department of Defense, and superbly practiced within most, if not all, army health centers. For any one not familiar with its key principles, it’s worth checking out the Agency…
Community

Collaboration in Science

On July 4, 2012, scientists at CERN’s Large Hadron Collider announced they had found the Higgs Boson – a fundamental particle underpinning the Standard Model of particle physics. The existence of this particle had been theorized by Peter Higgs in the 1960s but was never “found” until the CERN experiments. This was a big deal for particle physics. The Standard…
Clinical

Can we measure physicians and adjust pay according to their performance? – Part 1

We love ranking and rating things and have come to rely on them. What’s the highest ranked college that your kid can get into? Which restaurant has the best Yelp review?  Which beach did TripAdvisor rank as the best in the world? Rankings and ratings are increasingly permeating healthcare, too. US News and World Report already releases annual and ‘scientific’…