Unlike residency and fellowship, which are typically divided into discrete rotations or blocks; the passage of time in practice seems to flow in a relatively unobstructed fashion. Certainly the long winter drags on and business inevitably picks up as summer arrives, indicating the change of season. But, without distinct check points throughout the year, it is easy to forget to stop and reflect on interactions with those around you and how we could potentially improve upon the status quo.
In academic medicine, despite working with residents and fellows who have these built in assessment points, I still find myself practicing without a formal schedule for critical reassessment of the state of affairs. Even annual meetings with department chairs and division chiefs do not automatically lead to thorough self-reflection. However, as we approach the turnover of the medical calendar, when chief residents graduate and juniors magically become seniors, this seems to be a natural time to reevaluate and to potentially make “medical New Year’s” resolutions.
A New Year’s resolution is typically when a person resolves to change a trait or behavior or to accomplish an individual goal. As per businessinsider.com, approximately 80% of New Year’s resolutions are broken within 6 weeks of their inception. Perhaps we can be more optimistic about sticking with “medical New Year’s” resolutions if we resolve to target a single trait or behavior that would reach into all realms of our practice.
The most successful route would likely be to start simple- a single resolution that can be applied in many realms, instead of the laundry list usually created every year on January 1st. For my inaugural “medical New Year’s” resolution, I plan to attempt to improve my communication skills. This is a relatively simple entity that I can apply throughout my practice and that could potentially lead to significant improvements.
My resolution will be to improve my communication skills in three specific realms – in my interactions with the residents/fellows, in my interactions with the OR and clinic staff and also with my patients. Although communication is the unifying theme of this resolution, I would assert that targeting those 3 separate populations requires the improvement of 3 different skill sets. With my patients, I will try to spend more time discussing their pathology and making sure they truly understand the options and the eventual plan. This will require improved transparency and patience during every clinic visit. For the residents and fellows, I would like to communicate my expectations more clearly. I hope this will result in a better educational experience on both sides of the equation.
Finally, communication with the OR and clinic personnel: We often assume that our staff should know what we are thinking without actually outlining this verbally. The OR and clinic staff typically work with multiple different physicians and this can present a challenge in remembering or anticipating the thoughts of any individual. I will strive to replace my assumptions with clarity in communication.
For me, the start of the new academic year (July 1st) is an easy date on the calendar to try to annually remember to reflect. Regardless of what date works in your life, we can all benefit from annual self-assessment and attempts to modify and/or improve our current situation.
What an awesome aspirational goal Felicity! The vision–better communication—is the starting point. Your “logic model” to enact successful change needs to include an estimation of the inputs/activities that will be necessary—maybe daily briefs with your resident and OR team —to practice and model honest communication. The lead indicators are as simple as logging these regular meetings. The lag indicators are the ‘holy grail”—better patient satisfaction with their experience, clearer understanding of expectations and performance standards by the residents, and a sense of mutual accountability and shared espris de corp in the OR. One really critical part of any successful change effort is measurement—do the planned activities actually predict and contribute to change and are you able to measure whether the anticipated results are happening? Tracking this might be as simple as an open-ended question in the OR, with patients, and your residents: “How are we doing?” How often do we ask for feedback? Thanks for bringing such an inspiring idea to us midyear!!
Well written. Thank you for sharing this!
Finds some unique content on New Year Resolutions. Great Sharing!