Clearing Out the Clutter, in Our Drawers and in Healthcare
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Over the past week, there have been two large-scale decluttering events in my life.
Longtime readers of this column will recall that my wife’s family has a small house on a lake in central New Hampshire that’s been in their family for more than 120 years. Her parents used to spend 4 to 6 months of every year there during the summer, and family members and friends would come to visit at the lake. Over the years I’ve written several columns about recharging my batteries for a week or two up there, sitting on the porch, watching the sunset, sleeping a little late, swimming and kayaking in the lake.
It is now passing to the next generation, and it’s up to my wife and her siblings to decide the future of the house, and what work it may need to make it more comfortable and more livable. So a bunch of us descended on the house this past week and made some major decisions, chucking some furniture that was frankly unstable to sit or sleep on, and clearing out an office space that my in-laws had used for decades.
As happens in every family, opening up these office drawers revealed a lot. Memories got dredged up — some happy, some sad — and we discovered all the things that had been saved through the years. Everybody left feeling good about the place, confident that it was ready to move forward for the next generation.
The other major cleanup happened in my office, where we’ve had perennial problems with leaking. Whenever there’s a major storm that dumps rain on New York City, the drain spouts on the building get overwhelmed and water gets backed up. Pipes leak, and water comes pouring down into our offices.
Earlier this summer, while I was sitting at my desk one day supervising residents, I noticed that my shoes were suddenly squishing on the carpeted office floor. A team from the building’s facilities management group rushed in and declared that the leak was originating from me, and that water was pouring from my office down into the floor below.
I pointed up at the now completely soggy ceiling tiles of my office, and at rivulets of water rushing down the walls. “I think it’s coming from up above.” They dashed out, going up to the floor above, and on to the floor above that. Once the acute flooding was taken care of, I spent a few days sitting in a moist office with peeling paint and a moldering carpet.
The final straw was when the bugs started flying around. After a couple of visits, members of the facilities team finally agreed that the carpet needed to go and that my entire office needed a new coat of paint. They decided to do this while I was up in New Hampshire, and I’m looking forward to arriving back in the office tomorrow morning to new tiles on the floor and a fresh coat of paint on the walls.
Part of my prepping for this transformation was clearing off all of the surfaces in my office, 30 years of bric-a-brac, so that they could get the large pieces of furniture out and really set to work. I blocked off a few hours tomorrow to put my office back together, including going through my desk drawers full of decades of detritus.
We all have drawers like this, including the junk drawer where we put our pens, paper clips, charging cables, bottles of Pepto-Bismol and Aleve, extra plastic utensils from takeout food, and everything else that we might, just might, someday need. But I’m determined to cull this mess, to bravely throw some of my own stuff away. Whenever we declutter, we usually feel a sense of freedom, a weight off our shoulders.
What do these two events have to do with healthcare? This summertime pause with its major decluttering has inspired me to keep thinking more and more about ways to get rid of the clutter in healthcare that prevents us from doing our jobs, that burdens and burns us out, as well as those barriers to access that exist for our patients. I’m reinvigorated to fight back against prior authorizations, ridiculous forms that serve no purpose, senseless formularies created by people who are only interested in their own bottom line, the clutter of the electronic medical record that provides no benefit for patients or healthcare providers.
And then on to access, equity, health literacy, scientific truth…
I’m hopeful that the smarter systems we see coming down the pike with artificial intelligence will finally yield some benefit for us, alleviating the strain of all the things that don’t require us to use our clinical brains. We need to de-clutter the rest of healthcare so that we can once again build a system that we can be proud of, that delivers the right care to the right patient at the right time — and frees our cluttered minds.
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