Birds of a feather

September 6, 2013
Eric Postal, MD

Today's healthcare system seems to push providers further toward multi-tasking, preventing them from focusing solely on their patients.

One of the advantages of my every-other-week nighttime work schedule is that during the summer I can pretty much hit the beach whenever weather permits, rather than just on weekends to share the place with the rest of the population. It’s nice being out there with a minimum of other humanity, especially along the stretch of sand I prefer, which abuts a large bird-nesting sanctuary.

Sandpipers are amongst the local avian population. For those unfamiliar, they’re fairly small and make their living along the water’s edge, sticking their beaks into the wet sand as frequently as they can in the hope that they’ll contact something tasty. While they do this, they scamper forward and back to remain just above the leading edge of the water, which, thanks to the action of the waves, is constantly advancing and receding.

Watching a group of them hectically scurrying about in hopes of getting as many morsels as they could, I found myself in mind of our healthcare system. Specifically, a subpopulation of its workers (physicians and otherwise), engaged in a never-ending scramble to predict, understand, and adapt to its changing rules. Much like their feathered counterparts, they are willing to try dozens of times for each single instance of being on-target.

While a borderline-frantic lifestyle of scurrying for bits and pieces to subsist or possibly even get a little ahead of the other guy might suit some people, I am not among them. There are some fields out there that seem geared to such folks-much of the business-world, for instance. Sales. Real estate. Investment. “Always be closing,” as the line goes, or “you snooze, you lose.”

Healthcare, at least for me, was the opposite end of the spectrum. Most of the time, a physician is supposed to be a thinker. Patiently and carefully gather information, process it against an internal warehouse of wisdom, and embark upon a considered course of action, with subsequent adjustments as needed.

On the beach, another portion of the avian population seemed to embody this: the seagulls. (Apologies to readers envisioning filthy, garbage-picking scavengers and recoiling in disgust; the next time I see some magnificent falcons gracing the dunes I’ll revise my story.) In contrast to the borderline-frantic sandpipers, the gulls pretty much calmly stood their ground, leisurely regarding the world around them. Expertly sizing things up, they only budged when they deemed it worth the effort, but when they did so, it usually paid off. Where the sandpipers are scurriers, the gulls might be termed surveyors.

If you asked the typical member of the healthcare-seeking public which sort of physician they’d want treating them, scurrier or surveyor, I imagine there would be a clear-cut majority of folks preferring the latter. People want their docs to be fully focused on their patients, rather than twitchy and distracted by a constant stream of distractions from medical boards, licensing bodies, regulators, and multiple levels of government.

Of course, it’s not entirely a decision in the docs’ hands, any more than the sandpipers might suddenly choose to change their whole approach to foraging. We are in an environment which makes it difficult and even perilous NOT to be hyper-vigilant to the winds of change. It makes one wonder whether the entities generating those winds have a game-plan that depends on our being scurriers rather than surveyors.

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