Emergency Medicine News:
Fitzgerald, Robert T. MD
I remember the good ol’ days of emergency medicine in the 1970s. We were making it up as we went along. There were no guidelines, no protocols, no expectations. This was way before risk managers, quality assurance nurses, and patient satisfaction scores.
I remember ED committee meetings where we mostly talked about cases, trying to learn from those that went badly, praising the great call, anything that would help us provide better care in the new medical world. Life was simple then. You saw some patients, did your best because that's what good doctors do, and answered first and foremost to yourself and your patients.
How times have changed. ED committee meetings now are filled with quality assurance and risk management representatives who review your quality measure scores and individual, local, regional, national, and international rankings. Administration shares your patient satisfaction scores, and talks about opportunities for improvement. Even clinical cases are usually referrals from other committees looking for a meeting-the-standard-of-care number. Then someone from billing shows you your “profile” of revenue per patient visit, missed ancillaries, and percentage of downcodes, all neatly displayed in ?multicolored bar graphs. And the final indignity: Your door-to-provider time is six minutes longer than the group's average. The horror! But when was the last time a physician spontaneously opened with this statement: “I had a fascinating case last week that I want to share with everyone?”
I guess if you've grown up with this system and have nothing to compare it with, then this probably seems normal. Pity the poor physician who knows better, who misses the sense of camaraderie, sharing each others' medical and social faux pas, the laughter. Yes, the laughter, which came from the confidence you had in knowing you were doing your best, and had some control over your individual practice. When you did well, it was acknowledged.
How is the modern physician supposed to cope? How can he get through two hours of committee torture and tedium, of spreadsheet after spreadsheet proclaiming his “clinical” shortcomings? Here's the answer. Turn a negative into a positive. Hoist them on their own petard. For your amusement, I present “Buzzword Bingo!”
Here's how it works: Every time someone utters one of the following words, mark it off your bingo card. When you get five vertical, horizontal, or diagonal marks in a row, say “BINGO!” For the timid, this can be whispered under your breath with a knowing grin for the benefit of the other players. For the brave and soon-to-be unemployed, you can be a veritable Howard Beale in Network by shouting it at the top of your lungs. Either way, I'll guarantee the meeting goes faster.
Feel free to customize this for your institution!
Dr. Fitzgerald pract...Image Tools
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