February always feels like a post-mortem on the prior year. I’m wrapping up job-related paperwork and evaluations and preparing to begin to think about starting a plan for gearing up to confront my 2016 tax return.
It’s always the month I most desire to change my record-keeping habits. If I were more conscientious attending to the details during the year, pulling together these year-end documents would be easier.
But diligence in the details is, for some professions, a much more serious matter. And there is some evidence that I’m not the only one with something to lament:
It sounds appalling–my medical record isn’t accurate?!?!–and there is some reason for concern.
I have seen first-hand how this can happen in non-life-threatening situations, and I can imagine how the habit carries over into more serious ones.
One of my children recently went in for a routine childhood surgery, but for an atypical reason. That is, usually kids get his surgery because they have [the usual symptom]. He did not have [the usual symptom] at all, but had a completely unrelated symptom that made the surgery necessary. Somewhere along the way, though, someone entered “[the usual symptom]” into his chart, and there it stayed, no matter how often I corrected it.
I actually started counting. Seven times, a healthcare provider said some variation on “I see here he has [the usual symptom]–this should help with that” and seven times I said, “He doesn’t have [the usual symptom].” And seven times, the speaker said, “But it says right here . . .”
What was disturbing was that one of the seven people was the surgeon himself–the one who recognized the [actual symptom] and recommended the surgery on our initial visit. Perhaps he’s the one that wrote down [the usual symptom]. Or perhaps someone else did along the way, and the words on the page that supposed to record the initial conversation obliterated his memory of the actual conversation. The spoken word was drowned out by the written word.
In any case, I’m fairly certain his chart still reads “Patient complains of [the usual symptom].”
I don’t know why it wasn’t corrected. Perhaps some of them didn’t have the authority to make changes to his record. Perhaps most of them decided the difference was irrelevant.
It isn’t hard to imagine scenarios where the difference isn’t irrelevant, though. And I don’t think I was being unreasonable by wondering whether this inattention to detail was more significant than anyone else seemed to think.
It’s easy to develop habits of inattention, of laxity, of apathy, that snowball into outright negligence. Conscientiousness requires a daily commitment to excellence, a constant awareness that the work matters.
Although January is the traditional month for introspection and resolution-making, this month I’m doing it in February: “Be more faithful in the little things. It’ll help with the bigger things.”