Years ago, I was having dinner with 2 members of The
Cleveland Orchestra, one of the finest orchestras in the world. I asked them, with my kids present, how much
time they devoted to their craft. As
many parents know, getting kids to commit to practicing a musical instrument is
about as easy as splitting the atom in your garage. The musicians told us how much time they practiced,
which was mind boggling, as one would expect.
Any artist, athlete, Green Beret or similar professional, has to
demonstrate extraordinary commitment to maintain a superlative level of
excellence and preparedness.
I asked one of the musicians, the violinist, how long he
could refrain from playing his instrument before he noted some professional
slippage. Guess your answer. At the end of this post, I will relate his
reply.
How many hours are enough?
How long can you be away from your job before your
performance ebbs?For most of us, we can take weeks or longer on holiday and
return back to our positions seamlessly.
A few examples.
- Politicians return to Congress after long breaks and lose not a whit of their capacity for obfuscation and duplicity.
- New York City cab drivers return from vacation and can still take you on a ride of terror to any destination.
- An airline customer service representative a few continents away maintains state-of-the-art client service even after a month away from her cubicle.
What about doctors?
What about gastroenterologists?
Yes, I do take
vacations, but most of them are long weekends.
It’s rare that I take even a week off. Perhaps, the reason why I maintain
such a keen colonoscopic edge is because my absences are brief. If I took a sabbatical for 6 months, would I
be rusty when I approached my first rectum on my return?
Now, manipulating a colonoscopy when I bringing light into a
dark world is not exactly the same as playing violin in the Cleveland
orchestra. I’ll leave it to the reader
to contemplate which of these activities demands more skill.
Seriously, do physicians lose their cognitive and procedural
skills after an absence? I’m not sure
this has been tested, but I believe the question is a reasonable one for
patients to consider. Hospitals will
track volume of surgeries from specific surgeons, but a busy surgeon could meet
the yearly threshold, and still take several months off. Should a patient who is to undergo a cardiac
bypass or a colonoscopy after the physician has been away for a few months be
concerned?
Is medicine like riding a bicycle that one can do well after
a hiatus of years or more? Or should
doctors who have been off the bike for a while put some training wheels back
on.
Consider this the next time you are hearing music from a
master musician in a concert hall. One
thing is for certain. He hasn’t been loafing
on the beach. My musician friend told me that if he is separated from his instrument for 3 days, he can hear the difference even if we couldn't.
As a charge nurse I constantly have to deal with the problems of under staffing. I've seen first hand how under staffing can contribute to the untimely death of a patient. These administrators are aware of, and apparently have accepted, this increase in the mortality rate and now need to be held criminally responsible for those deaths. I feel once this happens administrators will start to do the right thing.
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