Research Activities, September 2013
From the Director
In this, my last Director's Column, I'd like to briefly reflect on how AHRQ's research and tools have improved clinical practice from when I first became a physician to now.
If you look at today's residents, they have the pockets of their white coats stuffed with little books, notebooks, PDAs, etc. They always want to know "What do I do right now?" AHRQ's clinical tools—such as surgical checklists, teamwork protocols, and our prevention guide that allows physicians to key in a patient's characteristics to identify the preventive tests they need— really build on this old-time model. However, all the operational pieces need to be in place, because health care has gotten a lot more complex. Medical simulation and other approaches help train residents in procedures and patient care.
When I first began as an internal medicine physician many years ago, I was never supervised or observed with patients. When I saw my first patient, a middle-aged man with diabetes and its complications, including eye disease, he told me as I was conducting the physical examination, "I come here a lot, and you're not going about this the right way." I was a bit taken aback, but I listened to what he had to say. And that was a lesson to me to listen to my patients, which has become the cornerstone of today's patient-centered care that takes into account patient's values and preferences in treatment decisions.
We've also figured out that clinicians can't just watch a Webinar to improve their practices. That's like watching the Food Network, which is very different from taking cooking lessons in your own kitchen. It's not just content, but actually doing it yourself. That's why AHRQ's clinical tools have been designed so they can be adapted and implemented locally at individual health care facilities.
In the end, these tools and our research help clinicians answer the question, "What do I do now, for this patient, in this situation?" That's a huge step forward compared to the resources available to me when I began as a physician, and it has made a huge difference in patient care and outcomes.
Carolyn Clancy, M.D.