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Time Out

Posted Sep 01 2012 1:05pm
I think one of the greatest concepts in sports is the timeout.   Players and coaches alike have the opportunity to signal the ref any time they need to regroup, reformulate their plan of attack, rest, or just shoot the breeze with their teammates.Timeouts allow a team to change the course of events and improve their chances of success.   Today, I adopted the concept of timeouts in my medical practice.   While timeouts are routinely used in my hospital’s operating room prior to surgery to review the patients chart, surgical site, and paperwork, until today, I had never implanted the approach in my office.Today, I needed a timeout.   I walked into a patient’s room having studied his office chart and emergency room notes.   I had already decided what was going on and what needed to be done (called “anchoring” and the subject of tomorrow’s blog) and proceeded to act on my brilliant plan of action and help my patient get well.   Five minutes in, the patient’s mother interrupted me with a question, followed by a statement that stopped me in my steps!   I had missed one vital piece of the patient’s history (blinded by “anchoring”) and was way off base on my diagnosis.   The emergency room had missed the same fact and the patient’s mother stated that no one was willing to listen to her!In essence, my patient’s mother had called a timeout and given us a chance to regroup, reach the right diagnosis, formulate an appropriate treatment plan, and help her son get well.   My patient’s mother and my patient were very gracious and, instead of holding my feet to the fire, accepted my human frailty and moved on.  I will hold my own feet to the fire.   I know better than to “anchor” myself to a diagnosis!   I guess I am a little too human at times.   Enough with the mia culpa, back to the subject of timeouts.   My patient, his mother, and I decided that, in the future, we would make the “T” sign with our hands and call timeout whenever we were confused, having trouble communicating, or just needed to think about the subject at hand.Yes, doctors and patients need to adopt the concept of timeouts.   If your doctor does not hear you, if you need time to digest what he is telling you, if what he is telling you does not ring true, or if you simply need to inject new information into the discussion, call a timeout.As your doctor, I reserve the right to call a timeout as well.   I look forward to introducing the concept of timeouts to my practice and believe it will have a positive impact on my practice of medicine.   I also will work hard to avoid prematurely “anchoring” myself to a diagnosis or treatment plan and hope my patients will work just as hard not to “anchor” themselves to their preconceived or internet generated diagnosis. 
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