I am not about to whine about how busy we are and how much work there is to do. Being busy at work is a given, I get it. Residency programs are tough. But what we really have to talk about is this: What is a doctor’s job and what not?
I have worked on more than ten different wards and all of them had their methods of torchuring a young doctor, who couldn’t object because it has been this way since, well …ever.
Does it serve the patient’s purpose if the doctor is mainly busy with the following tasks? Is it really a doctor’s job to
- take blood samples from a central venous line?
- send away the samples to the lab?
- write ECGs ???
- pick up a patient from his room to get him to the exam room?
- prepare a patient for a central venous catheter insertion (collecting all the stuff we need, positioning the patient, switching on the monitor, connecting ECG etc., preparing the ultrasound, draping, disinfection)?
- Check the fridge for blood products that have to be sent back to the blood bank?
- Check, whether there are enough syringes in the bronchoscopy cart?
- putting in gastric tubes?
Almost all doctors, I have met so far including me are afraid of asking these questions because that will make us appear
arrogant. (“Who does he think he is? Albert Schweitzer?”)
lazy (“He gets the biggest salary…”)
patient-distant (“All he has done was sit in front of the computer. It won’t hurt him going to a patient.”)
But the truth is: All day long I am so busy doing stuff that easily someone, who hasn’t studied medicine could have done.
This wouldn’t be so terrible. After all I’m getting paid for doing work, and being busy at work is not that big a problem. But the problem is it takes my attention from the really important stuff, that actually serves the patient big time.
If we actually say: Yes, all of the above described activities have to be performed by doctors that means that we accept that we have less or no time to do the things that only a doctor can do:
- study the patient’s exam results and lab values
- take a good history
- doing physical examination
- make a treatment plan
- talk to their family.
That being said, we have to think about what we do while we are at work. I encourage us to rethink the activities we engage in during work and to question our duties and our workflow in the place we work in.
This is not about turfing activities and duties to nurses. This is about substantially advancing the quality of our work.
So get this started with these three easy questions:
1. What can only be done by doctors?
2. Which activities do not have to be performed by doctors?
3. Who can do them instead? Physician’s assistants? Paid med students? Nurses?
Please leave an answer or a comment below.
