My Early PAhood Experience

           Looking back on when I began my path to PAhood, I can confidently say it was not an easy one. In fact, it was not even a straight line during those early years— it was more like a circuitous first path before I was able to settle down in my journey. In a word, it was more like a tough, dizzying roller coaster ride, while trying to thrive and navigate or hang on to the rough workplace “terrain” ahead of me.

Surviving an arduous career beginning without an employer’s or co-worker’s support can be daunting. Especially as a young PA graduate. On many occasions, it felt impossible to see the light at the end of the tunnel given the daily struggles trying to fit in while sidestepping difficult departmental or organizational politics or even toxic work-group dynamics. 

It is in these sticky situations where you have to grab yourself by the bootstraps and be patient with yourself and others. Keep in mind that mastering any learning curve is not going to happen overnight, no matter how much indirectly or directly you are made to feel pressured. As the old saying goes: Rome wasn’t built in one day–the same goes for any great careerist.

Do not saboteur yourself by allowing others to minimize you and rob you of your confidence. In due time you will become effective and proficient as you continue to develop your base knowledge and skillset. Experiential learning is an incremental process. Things and fact patterns will become easier to recognize while you continue to forge ahead and mature professionally in your craft. 

        In retrospect, I wish I would have been kinder to myself in those early days. Yet, sometimes we must go through these growing pains either early on or intermittently in a mid-career phase. But, in the end, the bottom line is all about respecting and asserting yourself confidently even when others may not honor your efforts or learning disposition you would like or prefer. Sadly, you may be bound to encounter some of these malignant folks along your path. Be resilient, and remain true to your goals. Be resolute…be focused, and always be measured and you will not be easily derailed by these career derailers. Moreover, and in essence, that is the best-guaranteed way to a very fulfilled PAhood experience.

The Robotic (Automated) Provider

            I think and feel I have a lot to say about how medicine is practiced in this fast-paced business of ours. I've seen it in my own career and in many other colleagues' careers too. In this commentary, I'm going to do something I've never done before or at least didn’t think about it on a deeper level. I'm going to dig deeper into an area of troubling practices, and, I'm going to show you where we have erred and continue to do so in our daily practices. More specifically, what we have become as modern-day clinicians. 

Moreover, why what we or you're doing isn't working as well as you'd like, and what to do instead? I'll show you one root cause of why and where we have abdicated our thinking selves. As medicine pushes for profits, we have been pushed to become “fast thinkers” when providing medical services to the patient community. In many respects, we have become too automated, even in my opinion too protocolized in many instances. Do not misunderstand me, I am not against abiding by following practice or clinical guidelines, or even abiding by organizational protocols. Obviously, they have a role in standardizing medical care. However, be that as it may be we have relinquished our clinical thinking to a robotic mode, or simply the activity of “checking boxes” in our minds.

Cognitive Psychology proves this very clearly. In their lingo, this is known as providers practicing Medical Heuristics (aka rules of thumb). Unfortunately, this unconscious mindset although very convenient for quick decision-making, oftentimes leads us astray in our medical final decision-making activities. Tragically, leading us to medically misdiagnose, or delay the appropriate treatment, as a result the plethora of potential medical errors and adverse outcomes we see occurring across the continuum of medical care. See, this is where we are all doing it all WRONG! Not slowing down to pause & think and look beyond the immediacy or even look at the big picture when making clinical decisions in our daily busy practices. In essence and sadly that has become our Achilles heel.

These battling internal and external forces for better or worse ultimately drive our decisions. As they say, we win some we lose some. But, I would argue to anyone to take the higher road: pause and reflect consciously upon the decision(s) you are about to embark on...solicit more information or much-needed data before proceeding. How do I know? Simple, I know this firsthand & better than most others because I have seen it from a medical-legal consultant perspective time after time. Primarily when I have served as an expert reviewer in alleged PA med-mal claims allegations. And there it is. In plain English & the spirit of sharing, I just had to remind you (my peers) of this ugly reality. One that lurks unnoticed in our daily practices.

            And from a Risk Management perspective, proactively mitigating your risks is what should be your bottom line. Simply by knowing and understanding how and when to implement these tips would definitively mitigate your potential legal entanglements. You must understand how to consciously sidestep them in your everyday patient encounters, whether it is in the office, ED or urgent care settings, or hospital. At the very least, it's another tool worth taking notice of in seeing for yourself what I'm talking about when you put these techniques into practice. It will give you a better understanding of the legal landmines lurking in the background, not to mention a broader view of your risk exposures. 

Start practicing safely and confidently...don’t take chances by being or becoming an automated provider. Better yet, don't sabotage your own career. Stay present, become an engaged provider, and allow your fast (unconscious) and slow thinking (conscious) to coexist harmoniously when making your final clinical decisions. Your patients will be less inclined to raise any potential medical malpractice claims knowing that you balanced your options before making a rash decision. You owe it to them...you owe it to yourself.