We are measured by productivity, by length of stay, and by time to chart completion. Accuracy of documentation. Core measure completeness. Attendance. Satisfaction scores. Order set usage. Ad infinitum. Some measure by the car, the house, the banknotes.
While aiming for compliance in these, I do not lose sight of the fact that my job is best summed up this way—I work for my patient.
If you see me upset and wonder why a lapse in care has me riled up. If you hear me tense in conversation or be a little short, while still trying to keep professional decorum. If you notice me walking briskly down the hall during the duty shift, just short of a sprint. If you find that I avoid long conversations during peak hours of the shift…please understand.
There is a vital metric that I pursue. I am an acute care physician. They call us hospitalists. Please understand, we specialize in the care of rather sick individuals. As we might sometimes say, “our garden variety patient actively trying to die”. Our average patient is at risk of rapid deterioration, often to the point of losing their life. Our job is to try our utmost to keep them safe. This task and challenge we face every shift, and for the nocturnist team, night after night.
So…while healthcare monitors its own performance metrics per the industry, by choice, I self-monitor. The index I home in on is a self-assigned, self-chosen metric. I call it the Metric of One. And I prefer zero, though I do not always succeed.
I do not wish for one, not a single patient assigned to my care, to suffer unduly, or pass away in a needless death, or to do poorly, if there is anything at all I could do to possibly prevent this. Sometimes illness is already advanced when we receive patients, sometimes the Grim Reaper beats us. Yet, if at all possible, if anything could be done to rescue a person who has presented to us for care, duty behooves me (and you, too, I hope) to give every diligent effort. At the very least, let it not be for lack of effort or lack of care.
So, understand. Bear with me. It’s not because of my ego, nor yours, not because I think I’m smart, not because of a number, a percentage, a metric. It’s because time is critical and human life is precious. I would not like to have any family plan a funeral that they would not have otherwise had to. I do not want a young man to lose the girl of his dreams and the mother of his young children, nor do I want an elderly lady to lose her high school sweetheart, who she has been with for more decades than I am old, if it would not otherwise have been time for their home-calling by nature.
This is what drives me. This is my duty…to my patients and their families. A patient is a person, just like me, and they matter to someone, more than we might realize. When their life force is extinguished, there is no getting it back. Tears won’t. AI can’t.
We don’t want to (needlessly) lose a single one.
This is my metric.
The Metric of One.
Enyi, MD
Dr. Abarikwu
Dr. E. Abarikwu is a nocturnist-hospitalist at Christus Mother Frances Hospital in Tyler, Texas. He serves on various committees related to the practice of medicine at local, organizational, and national levels. Away from medicine, he pursues several hobbies, including ice skating and triathlons.