We Recruit For Attitude And Train For

Making Systems Work Is The Great Task Of My Generation Of Physicians And Scientists. But I Would Go Further And Say That Making Systems Work - Whether In Healthcare, Education, Climate Change, Making A Pathway Out Of Poverty - Is The Great Task Of Our Generation As A Whole.

We Yearn For Frictionless, Technological Solutions. But People Talking To People Is Still The Way Norms And Standards Change.

I Talked To Over Two Hundred Patients And Family Members About Their Experiences With Aging, Serious Illnesses, And The Big Unfixables. But I Also Spoke With Scores Of Physicians, And Especially Geriatricians, Palliative Care Doctors, Hospice Nurses, And Nursing Home Workers. The Biggest Thing I Found Was That When These Clinicians Were At Their Best, They Were Recognizing That People Had Priorities Besides Merely Living Longer. The Most Important And Reliable Way That We Can Understand What People's Priorities Are, Besides Just Living Longer, Is To Simply Ask. And We Don't Ask.

At Times, In Medicine, You Feel You Are Inside A Colossal And Impossibly Complex Machine Whose Gears Will Turn For You Only According To Their Own Arbitrary Rhythm. The Notion That Human Caring, The Effort To Do Better For People, Might Make A Difference Can Seem Hopelessly Naive. But It Isn't.

In One Study, Old People Assigned To A Geriatrics Team Stayed Independent For Far Longer, And Were Admitted To The Hospital Less.