By Tracy Granzyk MS

First Posted at Educate the Young on 8/20/173

Tracy Granzyk MS, Managing Editor, Educate the Young
Tracy Granzyk MS, Managing Editor, Educate the Young

The Telluride student, resident and alumni reflections on our sister blog, Transparent Health,provide student perspectives on the patient safety teachings shared during their week at Patient Safety Summer Camp. For many, it is the first time they are exposed to some of the challenges found in healthcare.  Matthew Waitner, M2 at Georgetown University, who attended our first Telluride East session in Washington DC, shared his thoughts after digesting some of this content in a TH post,Trust and Safety in Medicine: Part One,

Matthew’s words echo what many of us working in patient safety can feel from time to time. Those who have gone the distance, however, have learned to find like-minded colleagues to bolster a strength-in-numbers approach. Rick Boothman, JD, a regular Telluride faculty member, thought leader, and ever-present voice in support of patients, read Matthew’s post from a distance this year, and shared the following comment in response. Rick’s words continue to inspire all of us — faculty and students alike. Thanks Rick–we missed you this year!

Dear Matthew,

I read with much interest the Telluride postings and I fully support Dave Mayer’s work which is deeply rooted in his conviction that though we might work hard to change the status quo toward improvement, you and your colleagues represent the very best shot we all have in making serious and durable change. We all have choices to make about how we spend the ultimate fixed resource – our time and passion; Dave has dedicated himself smartly where effort may yield the greatest benefit. His passion and commitment to the young is not misplaced and your post confirms the wisdom of Dave’s choice. 

BUT . . . as we identify what is wrong and work to correct it, it is equally important not to lose our way and destroy what is right. Understandably, after a few intense days focusing on the negative, you ask “Where is the outrage?”

Patience is not always a virtue, especially where lives are at stake. Without question, we’ve been far too patient with ourselves and the problems we’ve known about for a very long time. We must move deliberately and courageously to fix what’s broken, re-orient what’s misdirected, rethink what’s no longer relevant or useful.

BUT . . . I worry that you and your colleagues will despair. That you’ll lose heart. That you’ll lose the drive and the dedication and the determination to salvage what is right while fixing what is wrong even before you get started. That you’ll give up before trying.

Do not get jaded. Do not despair at the magnitude of the problems to which you’re being introduced. Despite more than thirty years of supporting health care providers in their very worst moments, I see more miracles large and small every single day. I see the positive difference all of you make for all of us. In spite of your human frailties and imperfections. In spite of systems that are fundamentally flawed, outdated and challenged by an unbelievable array of perverse incentives.

Despite thirty years’ worth of opportunities to become cynical, I am humbled every day by all of you.

Our daughter just finished her second year in medical school and she’s in the midst of her clinical rotations – I will never forget the sense of awe I saw in her face as she excitedly described for me and her mom the first time she actually laid hands on another person and diagnosed a heart murmur. And the overwhelming sense of responsibility she also felt when that patient put her life, her hopes, her body in my daughter’s amateur hands. I hope she will never forget that either. As I lawyer, I can only imagine that every one of you has had similar moments in your training.

Self-flagellation may have its place somewhere I suppose, but I don’t think it’s very constructive in general. And being overly condemning only makes the status quo hunker down in defensiveness.

As Dr. Mayer and his colleagues introduce you to the multiplicity and magnitude of the challenges we have, never lose your sense of awe. Work consciously your whole career to hold that profound feeling in your hearts and minds no matter what. Be proud of what you’re part of. And treasure the awesome privilege you have to touch us and heal us and help us.

We are all in this together.


Rick Boothman
Executive Director of Clinical Safety
The University of Michigan Health System

David Mayer, MD
David Mayer MD is Vice President of Quality and Safety for MedStar Health and is responsible for overseeing the infrastructure for clinical quality as well as for designing and directing systemwide patient safety and risk reduction programs for MedStar and each of its entities. Dr. Mayer founded and has led the Annual Telluride International Patient Safety Roundtable and Patient Safety Student Summer Camp for the last eight years. He regularly presents and writes on topics related to quality and patient safety for Educate the Young, and has received grant funding from the United States Department of Education, the Agency for Healthcare Research and Quality, and the Anesthesia Patient Safety Foundation.


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