It might seem like a stretch, but my recent encounters with clothes dryers have taught me a few lessons about what HM groups need to function at their highest level.
by Danielle Scheurer, MD, MSCR, SFHM
It might seem like a stretch, but my recent encounters with clothes dryers have taught me a few lessons about what HM groups need to function at their highest level:
I’ve had pretty bad luck with clothes dryers. Washing machines, no problem; I find them cooperative, reliable, long-lasting. But dryers and I are perfectly incompatible.
So I should have known I was in for problems when, last summer, we moved into a house with an old conveyed dryer. After closing on the house, I became the proud owner of the off-white, rust-tinted clothes dryer, along with the expired warranty and a stack of maintenance books. It motored along fine for a while, unattended by me (or anyone else in my household), until one day it just stopped. It stalled, mid-load, leaving inside a huge lump of wet clothes, and another, wetter load waiting in the washer.
So, not terribly surprised by yet another unreliable appliance but annoyed nonetheless, I Googled “dryer repair, Charleston, South Carolina.” A millisecond later, I found what seemed like a reputable, appealing name. Feeling like I was supporting local small business, I dialed the number and heard on the other end of a crackly landline the voice of “Fred,” his name changed to protect the innocent. After a few minutes on the phone with Fred, I imagined (later to be confirmed) a local Southern man with a broad-based baseball cap, low-riding jeans with a large belt buckle, and a knack for dryer-sized appliances.
His first logical question after my plea for help was: “What kinda dryer you got?” Hmmm, good question, since I never actually paid attention. Maytag? GE? “Umm,” I answered, “not sure.” Fred then uttered the next most logical question, this time sounding slightly annoyed: “Gas or electric?” Now you are getting a sense of how much time I spend around my dryer: “Umm, not sure.”
There was a pause on the other end of the line, and a pit in my stomach. I was thinking, “I can’t believe I am failing a screening test for this darn appliance.” As I considered making up an answer, he broke the silence: “Well … then I guess I’ll just have to pay you a visit.”
Lesson: It is pretty hard to take good care of your dryer, or to fix it when it breaks, if you don’t know too much about it. HM groups need to get to know each other, to have an understanding of what we are made of, and how we can help each other when in need of “repair.”
When Fred arrived at my house, he thoroughly disarticulated the dryer into remarkably small pieces. It didn’t take long after to find the culprit. There was enough lint built up around the innards to ignite a large factory.
Feeling a little defensive about my lack of dryer maintenance, I launched into a litany of complaints about my husband. “He doesn’t believe in lint traps, thinks cleaning them is beyond a nuisance, and only resorts to the task when gray dust bunnies are bulging out of the top.” It was about this time that Fred, with years of old-fashioned Southern wisdom, pointed out to me that I was lucky to have a husband that goes near a dryer; based on one-too-many husband-complaint sessions with friends, Fred had a pretty good point.
Fred was visibly disgusted with the lack of maintenance and care of this trusted appliance, because, as he later disclosed, he doesn’t just fix dryers, he actually loves dryers, which is respectable in a strange sort of way. I felt a surge of Catholic guilt about my lack of maintenance, so I vowed to Fred to take care of my dryer with all my ability, and thanked him for a job well done.
Lesson: If you don’t regularly maintain the lint trap, it all builds up on the inside, which can ignite a fire. HM groups need to regularly participate in “maintenance” functions, to keep the group humming along without risk of combustion. Such maintenance should include evaluation of roles, responsibilities, and reimbursement structures that result in equity and longevity.
After a few weeks of peace and harmony in the Scheurer household, without a single school uniform being re-worn with a ketchup stain, again, the unspeakable happened. An entire load of wet laundry sat in the dryer, stuck in park, with a wetter load in the washer. I flipped the switch; nothing happened. This time I even went so far as to “pop the hood,” just to look around (not that I knew what I was looking for). Without an obvious defect glaring at me, I closed the hood and, hesitantly, called Fred.
He promptly returned, on a Saturday morning, to my dwelling, and began the disarticulation process again. But before the third screw was off, he yelled, “Aha!”
Now, I wasn’t sure if the “aha” was going to translate into a “once again, you have proven yourself incapable of maintaining a simple appliance” when he disclosed, “the belt’s broke.”
What a relief; the belt broke. Surely I had no culpability for a broken belt. Alas, the broken belt had little to do with the uncooperative dryer; the belt broke because I had overloaded the old, pitiful thing. In an attempt at efficiency, I threw in a big, sopping load of towels, at least half a dozen too many, topped off with a bath mat.
Lesson: There is only so much efficiency you can squeeze out of a hospitalist group. If you load it up too heavy, it will break.
So you see, hospitalist groups really are a lot like dryers: hundreds of brands and model types, differing slightly in maintenance requirements and load-bearing abilities, but all sharing some common denominators: a need to be understood, a need to be maintained, and a need to not be overloaded.
So ask yourself the following questions about your group:
If you don’t know the answers, you should probably find out...or else call Fred.
Dr. Scheurer is physician editor of The Hospitalist. Email her at firstname.lastname@example.org.
The Hospitalist newsmagazine reports on issues and trends in hospital medicine. The Hospitalist reaches more than 25,000 hospitalists, physician assistants, nurse practitioners, residents, and medical administrators interested in the practice and business of hospital medicine.