Thanksgiving #2 During Pandemic: giving thanks

Dear Reader. This is an email I sent to my Large PIG (physician Informatics Group) this week. I wish you all a restful holiday. CT

Dear Provider Informatics Group members: My General Medicine Division Chair sent this today, and it makes me reflect about Thanksgiving. I wanted to pass this along to you. It has been 20 months of chaos, emergency changes and emotionally draining life at work and outside work.

“The arc of the moral universe is long, but it bends toward justice.”

Martin Luther King

It is a reminder that in our day-to-day, all we see are boulders and rockslides in our path. In the long run we are bending the path to reduce burnout, improve connection and improve care. Our work affects 6000 providers, 15,000 nurses, and a couple million patients. 

I am thankful to be on this journey with you. I hope you can take some time this week with family and loved ones. CT

—–

From: Earnest, Mark
Subject: Giving thanks 

Dear GIM Colleagues,

Ms. Sutton, my third grade teacher, taught me to start letters that way – with the word “dear.”  

Since leaving her classroom, I’ve not really given the word much thought.  Aside from placing it at the start of letters, or employing it generically as a term of endearment for my wife, I haven’t used it much.  I use it even less now since “hi” or just a stand-alone first name have become de rigueur for email greetings.  Using it less, I think, is a mistake.   According to Google, “dear” means “regarded with deep affection; cherished by someone.”

Today, I want to use the word with intention. 

So, let me start again.

Dear GIM Colleagues,

We are approaching the one day in our calendar each year that we set aside for thanks.  I’ll confess that after 20 months of the pandemic and all the associated fire-drills, chaos, and public acrimony, I’m much more facile at bringing to mind the things I’m not thankful for.  That may be the most compelling reason to devote my attention this week to its intended purpose – focusing on the things in my life that I cherish and regard with deep affection. 

I’ll not bother you with my gratitude list in its entirety other than to say how much I look forward to a house that is again filled with its full complement of family.  I do want to reflect for a moment on work.

As a young man, choosing a career path, I was clear about one thing.  I didn’t want a job.  I wanted a purpose.  I was fortunate to find that calling in medicine and ultimately in GIM.  I chose well.  I have always loved caring for patients.  Along the way, I’ve found other, related opportunities for growth and points of purpose: teaching, mentoring, helping others find and actualize their purpose…  In all honesty, work for me has been a great source of joy and satisfaction.  A wonderful side effect to finding my purpose, has been the privilege of working alongside other purpose-driven people.  If I could start from scratch and hand-pick a group of people to take this journey with, I could do no better than you – my dear GIM colleagues.  It is a profound privilege to be part of such a caring, committed, selfless group of people. 

Now – after twenty long months and in the midst of a surge – is almost certainly not the easiest time for any of us to hold our work dear.  It has been hard.  Nevertheless, it is possible to be tired, even exhausted, and thankful at the same time (ask any marathoner at the finish line).   Unfortunately, we are not yet at the finish line.  We have a challenging winter ahead of us.  That in and of itself should be reason to pause and reflect. 

I hope this week that each of you can find a moment to consider our common purpose(s) and find the space to be thankful for it.  Doing so need not deny the challenges we’ve faced or the sacrifices made.  Each day, in ways big and small, you have all made our world a little better.   Because of your work, each day there is a little less suffering, a little more hope and a little more knowledge and understanding.  Surely that is worthy of thanks. 

I am not aware of much more we can do to turn the tide of the pandemic.   Somewhere ahead of us is a finish line.  We will face more challenges before we cross it.  We cannot control all of those difficulties, but in the months ahead, we will be focusing on the ones we can change.  We will be looking closely at the circumstances and structures that impede our purpose and make our work, particularly our clinical work, more difficult and less joyful.   We will be looking for meaningful, actionable ways of rethinking and restructuring our work to make it more joyful and sustainable.

In the meantime, I hope you all can find the space to feel thankful for what you’ve done through this great time of trouble.  I am thankful for each of you my dear colleagues, and hope that this week you will enjoy rest and gratitude among those you hold most dear. 

With gratitude and thanks,

Mark

Mark Earnest from History Colorado dot org website

Mark Earnest, MD, PhD, FACP|Professor (Pronouns: he, him, his)
Division Head –  General Internal Medicine
Meiklejohn Endowed Chair of Medicine

Making clinicians worthy of medical AI, Lessons from Tesla… (statnews)

Novel idea: ensure docs KNOW how to operate AI (!) (image: ETHAN MILLER/GETTY IMAGES, via Statnews)

Here is a different take on AI in healthcare: train and only allow clinicians who understand the limitations of AI, to use AI. Make savvy clinicians better. Don’t give it to all clinicians.

This is a throwback to our experience with Dragon Speech recognition over the past decade: DON’T give Dragon speech to a clinician struggling with computer use; instead, give Dragon to a clinician who is computer-savvy and understands the limitations of Dragon.

But, (in the early years) give the non-computer savvy clinician an “opt out” to dictate their notes by dictaphone or telephone, and gradually bring them along.

Having given several non-computer savvy docs access to Dragon in those early years, our hair stood on end when we ended up reading their notes later: they were clearly NOT proof-reading their work and assuming the Dragon engine was perfect at transcription.

Back to the future.

CMIO’s take? Be careful out there, everyone, both on the road with Tesla, and in healthcare with AI.

An AI-human bill of rights?

https://www.wired.com/story/opinion-bill-of-rights-artificial-intelligence/

Read the Wired.com article. In brief, it outlines the emerging risks of relying on AI (artificial intelligence) tools that can unintentionally create bias and other consequences.

This is a nascent class of technology that, at its root, is often a black box: what is inside, is opaque to us, the users, and often to us as the designers.

I feel this critique personally. Having participated in the design of several AI tools in healthcare, I worry that, although we do our best, we don’t know what we don’t know.

CMIO’s take? I have no “best practice” lessons to impart here, on bias and the unknown. Do you? Please share. This is a big mountain we are about to climb, and we need to help each other.

Chimerealism

Mashing ideas together

Greg's Webvault

this is where Greg puts stuff he wants to keep

Discover WordPress

A daily selection of the best content published on WordPress, collected for you by humans who love to read.

Daring Fireball

CT Lin's CMIO Blog

ALiEM

CT Lin's CMIO Blog

HIStalk

CT Lin's CMIO Blog

the other fork in the road

navigating life via acute corners, wrong turns and dead ends