Getting It Right The First Time: Is That Professionalism?

By

Leonard Zwelling

There may be nothing more challenging than handling a home crisis of the infrastructure kind at a distance, but on Friday, July 5, that was my fate.

I was on vacation in Santa Fe, New Mexico when I learned that two large problems had arisen at my home.

The first had been an ongoing battle for a few weeks before we left. It seems that the Jacuzzi attached to our backyard swimming pool had been possessed by demons. In the afternoon, it would spontaneously trigger. The air bubbled up from the vents unbidden by anyone. The original diagnosis by our pool service company was that the airline that triggers the bubbles had been somehow damaged when a deck was put in 6 months ago and that explains the phantom bubbles. Nope. They replaced the line and the problem remained. Fortunately, son Andrew got to the house and was able to fill the Jacuzzi and slow the air bubbles. We await the resolution of the problem, but the company has been out at least three times and still cannot get it diagnosed or treated yet. They are not very professional.

Then an alarm in the house was triggered and the monitoring company notified me by email and phone call. The police were dispatched. They found nothing amiss. My son once again stepped in to find a major leak in the ceiling of the first floor, water on the floor and his sink overflowing upstairs. The smoke alarm was activated by the water.

The air conditioners drain through the sinks to the outside and a line got clogged and backed up into his sink. (He doesn’t live with us any longer so it went undetected over the Fourth of July holiday). We called in the A/C company who came the next day to unclog the line. The repairman assured me over the phone that all was well in the house.

An hour later my son calls. The A/C won’t turn on. I had to call the repairman back. He returned and found that the Freon was low in the system and found a leak in the condenser coil. That will be a costly repair. Why he couldn’t make sure the unit was working before he left is beyond me.

In both of these cases, people sent to repair infrastructure in my house, at very high rates of pay, failed. Neither problem is fixed yet and the weekend came. I will have to deal with this all when I return.

My points are: you can’t get decent help any more and even when the help shows up, they are not professional in their performance.

That brings me to the performance of doctors and nurses as well.

More and more I find the next generation of caregivers unwilling to go the extra mile to help patients as we were taught was our duty to do. When their shifts end, the new docs and nurses can’t get out of the hospital fast enough. When they are off, they are off no matter how desperate the need of one of their patients.

Clearly, the blood transfusion incidents that CMS found at MD Anderson are examples of lax oversight of the care given in certain parts of MD Anderson. In the rush to promote “professionalism” at MD Anderson, Dr. Pisters may need to consider starting by promoting competence. And if this is not what occurred, then Dr. Pisters needs to repair the communicators in his Public Relations Department as they seem unable to get the story out correctly.

Getting it right and getting it right the first time is a hallmark of a professional. Surgeons often don’t get second chances. When they do, as was necessary in the case with my abdominal hernia repair, I gave one surgeon two shots to get it right. When he failed, I got a new surgeon who got it exactly right.

If medicine chooses to do some necessary introspection, it should consider the wisdom of the new way young physicians are educated and trained. Yes, my life as a Duke intern was a living hell, but I never considered not giving my best then or later when a patient’s life really was in my hands.

If Dr. Pisters wants to raise the level of clinical care at Anderson, and the findings of the CMS suggest that there’s a long way to go, perhaps he should start by making sure that ALL the doctors and nurses know what the heck they are doing and care less about whether or not they treat patients like family. That’s not what cancer patients want anyway. They want accuracy, urgency, and good outcomes. Give them that and they won’t care all that much about the social skills of the caregivers or whether or not they say hello to one another when crossing on the pedestrian bridge.

Leonard Zwelling