During my year as an emergency department physician in a ski resort a woman came in with a sore throat. As I was working through the diagnosis, she stopped breathing. I remember her lying on the gurney, turning blue. I immediately shifted from the steady rhythm of a routine work-up to emergency mode – focused and fast. She required an emergency tracheotomy (making a hole in the trachea, or breathing tube). We had neither the equipment nor the specialists to stabilize her long enough to figure out what was going on. We loaded her into a helicopter, flying her from our rural town on the eastern side of the Sierra Madre to a fully equipped trauma center.
As I think back on this I recall traits necessary in an emergency situation. Clear, focused thinking and being calm in pressure-fueled situations are critical. I didn’t have time to say, “Oh, I’ve never done this before. I don’t know how to do it.”
I still have the letter from that woman thanking me for saving her life. It’s like penicillin to the infection of the Imposter Syndrome – not a cure-all but definitely a strong broad-range ego antibiotic.
Leadership Anemia
Managing a patient with only hypertension or managing a patient with only diabetes is much simpler than managing a patient with both conditions. Caring for patients, especially with chronic diseases and comorbidities requires a team. Some medications for hypertension are not recommended to be used in diabetics, and diabetics with hypertension may need additional medications. In such a case, the care team could include a primary care physician, a cardiologist, an endocrinologist/diabetologist, an ophthalmologist, a nephrologist, perhaps a surgeon, a diabetes educator and a nutritionist, each of whom may be communicating asynchronously with the others. Or not.
Hospital medical errors are now the third leading cause of death in the US. Poor communication is one of the leading reasons for preventable errors – often during the time when the care of a patient is handed off to the next physician or team.
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Patrick Williams
April 15, 2015 at 6:35 am
Dr. Cary has written here , a truth telling article about the unique challenges of physicians…..of whom we know so little and judge so often. Dr. Cary’s, background as a physician, and now as a caring leadership coach, allows perfect insight into seeing physicians in a leadership role and using the essentials of coaching. This article is a great example of the keys to differentiating Technical leadership versus Adaptive leadership. There are few professions that require skillful adaptive decision making and leadership than being a physician and Dr. Cary in this article offers great insight and guidance.
Elaine Holmes, M.D.
April 16, 2015 at 9:07 am
Very interesting, honest, and well written
Catherine Robinson-Walker
April 19, 2015 at 11:12 pm
Well said, Maggi. This is an important, honest article that touches on much of what isn’t working in the healthcare system today. Thank you, Dr. Cary!
PS. I have written about the imposter syndrome in healthcare, too. However, your weighing in as a physician adds important dimension. Thank you!