Eventually We’ll Get It Right
There's nothing like a reunion for making you feel old - and different, and special, perhaps. Last week, I went to the 25th reunion of my medical school class (Baylor College of Medicine, 1989). The events seemed to represent what's happening in health care today, specifically some of the issues facing America's Blood Centers.
First, the simple size of the party spoke volumes. We graduated about 168; about 25 showed up. We were not joiners then, and we are clearly not joiners now. We are reluctant to give up either professional weekdays or weekends to attend events. Honestly, I probably would not have attended if I had had to get on a plane. And it is not because social media has overtaken real meetings; someone set up a Facebook page, but it has been infrequently visited. Like ABC meetings, the reunion was competing for time.
In terms of time, we did not train under the current restrictions of housestaff hours. At that time, residents in the surgical program spent one night on (in the hospital) and one off for four or more years. Medicine and pediatrics were one on, two off, which felt kind of soft. Interns now are not allowed to spend any nights in the hospital, and hours are restricted for upper level residents. We will not discuss here whether this has been better for patients or for medical education, but it is certainly different. The education model is now different too. It used to be "see one, do one, teach one" for nearly all procedures. Now learning medics are judged on "competencies," with boxes to check that are more like the certifications we offer to satisfy CLIA regulations.
We have learned that the work we do involves money. Not a revelation, but something rarely mentioned in medical school. When we were students, healthcare economics was limited to consideration of the "gold card" at the county hospital where we trained. The card indicated eligibility for care and was often shared among family and friends. In our reunion panel on careers, several mentioned the amoeba-like movement of their medical practice from a small group to a large group and the decision to be acquired by a hospital - or not. Medical knowledge and skill, like blood, sometimes feels like a commodity.
And yet, my class still has, like those of us in the blood world, a special feeling of camaraderie. We are now a chair of an orthopedic surgery department, a medical writer, an ophthalmologist, a private pediatrician, an academic cardiovascular anesthesiologist. The whole point of it in the end - the medical education or the production of red cells - is to help the patient. We were trained to serve patients - whether in medical school or in another way as we entered blood banking - and that we will continue to practice. Eventually we will get it right.
Susan Rossmann, MD, PhD, Board Vice President; firstname.lastname@example.org