October 16, 2015
By Kim DiGioia, MSPH
Wade Iams, MD, chief resident in internal medicine at Vanderbilt University Medical Center and RightCare Action Week captain, is working to understand how practice changes to improve the healthcare system can be made on the ground.
In medical school at the University of Michigan, Iams learned a lot about healthcare expenditures and inefficiencies within the system. But upon entering the practice of medicine he found uncharted territory and unanswered questions about how best to provide high-value care. He hopes to increase value by shifting the focus away from the virtual realm and toward making each patient interface meaningful.
One of the ways Iams is doing this is by following the advice of Atul Gawande and asking patients an unscripted question (an idea that Gawande attributes to Paul Auster). Iams asks questions on topics that range from TV, sports, and family life, to “What does this diagnosis mean to you?” He feels that getting to know patients on a personal level and understanding their disease in the context of their life allows clinicians to provide better care. Yet, as many patients can attest, it is not the norm for a doctor to ask this kind of question.
Iams believes that to encourage more clinicians to connect on this level with their patients, we must first combat the perception that such an action is a waste of time, along with the reality that clinicians’ time is in short supply. This will take a combination of approaches, he says: infrastructure changes, large data, and leveraging the power of the adverse anecdote.
As part of his efforts to ascertain what each patient’s unique needs are, Iams is participating in RightCare Action Week and hosting RightCare Rounds at his institution. The RightCare Rounds discussion will center on practice management and blood culture utilization, and will include a diverse audience of residents, specialists, and hospital administration.
Iams is confident that when we get better at providing the care that is in each individual’s best interest, our system will become more efficient and better enable clinicians to provide the right care for all patients.