care coordination

Things I’m Reading: Mental Health Edition

Here’s a quick run-down of some of the things I have been reading lately:

  • What is the real toll of war on our veterans? A beautiful photo series highlighting what it’s like to live with PTSD. For another take on living with and living through a traumatic experience, see my recent post about the broken and yet unbreakable Kimmy Schmidt.


Palliative Care and the Lost Art of Communication

The following is Part 2 in a series about end-of-life care. For Part 1, see here. This article addresses my own experience on a Palliative Medicine elective in my fourth year of medical school.

Despite the growing number of U.S. hospitals with Palliative Care teams, there remains a real lack of understanding about the benefit that specialized Palliative Care providers can bring for patients with advanced illness. This form of care is especially valuable in patients with end-stage illness (and has even been shown to extend life by several months), but it can also help any patient at any stage of illness (regardless of prognosis). Indeed, even prescribing an NSAID for headache can be considered a form of palliation. The focus is about improving quality of life now instead of later. (more…)

The Checklist Itself Doesn’t Matter

Anyone who understands systems will know immediately that optimizing parts is not a good route to system excellence.…We connect the engine of a Ferrari, the brakes of a Porsche, the suspension of a BMW, the body of a Volvo. What we get, of course, is nothing close to a great car; we get a pile of very expensive junk.” – Chapter 8.

I just finished reading Atul Gawande’s The Checklist Manifesto, which was first published in 2009 and spent some well-deserved time on the New York Times Bestseller List. Written by an attending general surgeon at Brigham & Women’s Hospital in Boston, this book tells the admittedly “unsexy” story of how a simple tool such as a checklist can improve the quality and consistency of outcomes in a wide range of fields: aviation, building construction, venture capital, and (even) medicine. All of these fields are complex systems – involving many moving pieces and players, and an inherent unpredictability of conditions, materials, personnel, and complications. In addition, these arenas assume a certain level of skill and require a high standard of consistency and safety, but errors and complications still plague us. We have reached a point in many fields where the problem isn’t ignorance (we do understand a lot about the world around us) but rather ineptitude (we fail to apply the knowledge that we have consistently and correctly). A checklist can help us improve our “eptitude.”