This is what to remember in health reform: We are all one patient

As a physician, I am often discouraged when I turn on the news and read about the state of health care in our country. I can see all 397 sides of the debate and some truth in all sides. The enormous cost of medicine is overwhelming to comprehend for patients and families and even to those of us in medicine.

I think it is important to know all that goes into the complex care of one patient. I am an anesthesiologist, but there is no way I could do my job without a large team. Each of us plays a role in the care of one patient.

I am part of a team of people whose sole job every day is to care for you, our patient. In surgery, we start preparing well in advance, from the people who prepare the proper instruments and stock the drawers so in a second’s notice I have what I need to save your life, to the schedulers who triage add-on cases and bump elective cases to take care of life-threatening events.

There is so much that goes into the care of one person. It is not just one doctor or one nurse who delivers your care. We are the nuts and bolts of a well-oiled machine that requires everyone to show up, day in and day out, and do their part.

The other day I had to fill in for my nurse. She was with another patient, and she asked me, “Dr. Shillcutt, when you are done seeing this patient in the preoperative clinic (where we as anesthesiologists see you before surgery) can you take him to the echo lab?” I agreed. It was not too far from where I was headed next.

What happened next is somewhat embarrassing but proves a point: I started walking with this kind, elderly man quite a distance, and as his breathing became more labored, his walking slowed. It became rapidly apparent to me that I foolishly had left the clinic without a wheelchair, was in the middle of a busy hospital with no transportation, and my patient was in trouble. Luckily for me, a medical technician walked by and asked if she could help me. She rushed and found a wheelchair, and I sat my patient in it and wheeled him to his destination as he caught his breath.

When I told my nurse what happened, she scolded me and then she laughed. Of course, any of the staff in the clinic who take patients from A to B would not have made the mistake I did. My best attempt to fill in the gap — simply walking someone from A to B — still fell short.

We are a team in medicine. We must realize that each of us plays a part. I could not do my part without the surgeon, and she could not do her part without me. I couldn’t function without nurses and respiratory therapists and surgical technicians. I could not be a cardiac anesthesiologist if I didn’t have perfusionists there to run the heart pump.  If there weren’t critical care doctors and nurses to care for the patients after surgery, patients wouldn’t survive their post-operative state. If the pharmacists weren’t there to help me with drug therapy and to answer my questions in difficult cases, I couldn’t deliver the care needed. The more I think about it, the more proud I am to be on such an amazing team.

We need people to manage our supplies and equipment and schedule and billing. We need quality and safety folks and people to help us stay well. We need administrators and resource people and leaders. And we need to appreciate the depth of our team, the skills of our colleagues, and the importance of everyone bringing their whole self to work each day.

At the end of a long day, when I am taking my patient to the crucial care ward or recovery room, I often look over my shoulder as we all scatter and prepare to do it all again tomorrow. I often am amazed at the feat we just pulled off, and the moving parts it took to care for just one patient.

We are ONE patient.

We are ONE.

Let’s remember that.

Sasha K. Shillcutt is an anesthesiologist who blogs at Brave Enough.

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