The gift that keeps on giving

This time of year is one of my most favorite times. The weather is cool and crisp, Thanksgiving and Christmas always take me back to fond childhood memories and it is a time to slow down a bit and reflect on the things that truly matter, like family and friends. But with this time of year also comes the craze and chaos of shopping for the perfect gift! The challenging part for me is the sense that some have of being “obligated” to buy someone a gift because that is what is “expected” of them. Now don’t get me wrong, I am all for giving gifts, but not under the pretense that this is what I’m supposed to do during the holiday season. Before I get to far off topic this concept of expectations also drives some of the different methods of patient care that I see being implemented. I have had conversations with clinicians where they discuss their clinical practice preferences based mostly on what is expected. In the world of health care we talk about Evidence Based Medicine. This model has three main tenants; the clinicians experience/expertise, the best external evidence and the patient’s values/expectations. Collectively these three pillars should drive what we do as clinicians. However, I feel that at times health care providers do most of what they do because they feel that is what is expected and they use less of their knowledge or what the current evidence has provided. I whole-heartedly agree that we need to meet our patients at some level and have a common understanding together. To me that is a huge part of the goal setting process that should be done with the patient. What we can’t do though is perform treatment just of the sake performing treatment. Much like the feeling of obligatory Christmas gift giving, our patient care needs to incorporate much more then expectations. I do support the idea of feeling obligated as a clinician. I feel obligated to push patient care to be the very best it can be. I feel obligated to help drive my profession and other clinicians to be the very best we can be. These are the things that I feel are “expected” of me and I hope that as we enter into the new year more and more patient care is centered around this as well.