|Articles|May 7, 2015

Earning a spot on the medical team

Last month, I wrote about diagnosing my father-in-law’s branch retinal artery occlusion (BRAO) and then teaming up with a vascular surgeon for his subsequent carotid endarterectomy. After the successful “slam dunk” surgery, the nurse who discharged him advised him to “go to the ER” should he have any changes in vision, and in the process, dropped the ball.

Last month, I wrote about diagnosing my father-in-law’s branch retinal artery occlusion (BRAO) and then teaming up with a vascular surgeon for his subsequent carotid endarterectomy. After the successful “slam dunk” surgery, the nurse who discharged him advised him to “go to the ER” should he have any changes in vision, and in the process, dropped the ball. I promised you a breakdown of the game film of that sequence, and here it is.

Working as a fist

Duke coach Mike Krzyzewski (by the way, congrats Coach K!), once said, “A basketball team is like the five fingers on your hand. If you can get them all together, you have a fist. That’s how I want you to play.”

Obviously, all of us involved in my father-in-law’s care could have done a better job of talking and working with one another to better coordinate his care. We weren’t a fist. We were five spread fingers, waving in the air, doing our own thing.

The problem started with my father-in-law not being a part of the integrated healthcare system in which I practice. I’m used to typing, pointing, and clicking a patient toward the test, procedure, or therapy needed. When I need a consult, I hail the proper provider or clinic on my team. They recognize my digital “hand signal,” smoothly catch the ball, and go to the hoop. Well, most of the time anyway.

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