Trapped between two worlds.

Today i ran into a medical student, that got caught between the two worlds i earlier described in a blogpost two years ago. Looking back again facing end of year, brings back memories and ambitions, just like two years ago, so i thought i might share this one with you.

Yes, you can not avoid it anymore: the New Year's reflections and ... this is again one of those. If you can not stand this, start browsing. If on the other hand you care about healthcare, then perhaps you'd keep reading a little ;-)

This year had heights and depths, for myself and for people around me.
One of the moments i'm not sure of in which one of those two categories to be placed, is the realization that something is wrong with healthcare when it comes to medical schools. A low point might be the presence of the problem and as a highlight would probably just the getting aware of it, and then take the option to get started to work on it.

Context:
Ratio: We try to transform our best students into the best doctors. In addition to evidence-based practice (EBP) we "fuel" them full of protocols, guidelines, decision aids, checklists, stir up competition to be the "best", and go for nothing less. (Yes, I know I made this much too easy to go, but to make my point it is necessary)

Emotio : Patients (and their families) are aware of, have more and more information, compare sites are sprouting like weeds from the ground, and if the patient is not getting what THEY had invented something really is wrong (Yes, I know I made this much too easy to go, but to make my point it is necessary)

"Com-Passio": Probably every medical student stept into medical school because he or she really had a huge passion for healthcare, mesmerized for medical or because they have had an experience that triggered them to go and do it themselves ánd better. Often boys and girls with a mission, a clear goal and a tremendous drive to do better and a great heart and soul get into this.

In my ambition to change relationships in health care, to encourage, assist, strengthen and bring to the attention what we call Participatory Healthcare I often speak to medical students. Early in the process we've chosen not only to try to engage the "sitting crew" to get started also working with "our future leaders ". I speak regularly with medical students from different faculties about what these changes for them (can or could) mean and also what would be required in order to impart training to give form and content, to support them and prepare.

In the time that my own mission to Participatory Healthcare as possible (partial) solution for the care, was formed, it became clear to me that com-passion should get back into healthcare. Precisely the passion needed for this is what I found with many, if not all, in the students. However, there is a big "but" : almost without exception they addressed to me that this passion under increasing pressure placed upon the system and the content of training is disrupted. For understandable reasons, all the ratio's are of course extremely important, but on the other hand this relationship does not normally mix simple with the emotional and "com-passio" side, only few understand the art of finding the balance of this.

Slowly but surely we bring our new generation of doctors and nurses in a difficult position in which they themselves have little or no influence. They get caught in two worlds. They indicate at any moment to "surrender to the system", some are even considering to drop-out, others choose to step down after their education to try a policy- or administrative position to hopefully change "the system" themselves.

What I hear shows similarities with a study done in the U.S., showing dramatic figures show the suicide rate as our male doctors is 40% higher than average and even 130% among female doctors.

Wouldn't it be tragic if young people with passion and drive to deliver great healthcare, become disillusioned, adjust their goals or even quit. Instead, we must ensure that the healthcare (again) gets a place to be fun to work, to help people getting better and you have enough (realistic) challenges in your work experience. We are facing a tremendous challenge in terms of labor market issues, cost explosion, and the needed involvement of the patient and informal care.

The St. Elisabeth Hospital Tilburg launched a "campaign" to the hospital in the Netherlands to become the "nicest" hospital, and at Radboud University Nijmegen Medical Centre we stopped to be patient-centered, but instead started to embrace the patient, his/her family and the informal care into the healthcare team. The Rotterdam Eye Hospital has a anxiety reduction program to create better care for their patients. In addition to the basic trends are all steps are patient safety and quality targeted approached rather than a treatment or professional approach.

As a "rebel with a cause" I try to build and use a toolbox for healthcare we call, "Reshape". In this context we try to contribute to the above by working out (partial) solutions. So we are working to address this aspect for our own educational system to see if, how and what we can change in the curriculum, whether we choose this in free choice colleges. But at least to ignite an open discussion about it.

In addition, we try to provide a platform to this development to gain compassion for care.

To that end, I started meeting with students on a regular bases to make a change from their effects and to hear what is happening. One of these meetings was a kind of watershed-meeting in Utrecht in August 2010. Students, almost all involved in the IFMSA, and i agreed into a this joint action. These guys and girls are destined to contribute to this change.

First I had a short video teaser made to be used to issue to address, we agreed on a Compassion for Care conference for, by and with medical students on this subject to be organized, even before TEDxMaastricht , and anywhere on this issue considerable attention will be boosted.

We had cross-links with the Charter for Compassion by Karen Armstrong.
And in the meantime the Compassion for Care, movement is finding it's own way, after we've firestarted it with IFMSA and the Radboud REshape & innovation Center, with a very special and exciting occassion on TEDxMaastricht.

Let's see how we can help the future generation, which are to get in position to take care of us once up on a time, to find support and inspiration,(will) work by to the Golden Rule, and what things to do within in our power to make this possible.

May 2.0'12 bring you 2012 good ideas and inspirations to make healthcare better.

The great videoat the top was shot by Ronald Pupupin in our Radboud University Medical Centre Nijmegen and is called "Compassionated".