Responsibility: In and Out of Your Practice

June 28, 2011
Jennifer Frank, MD

Whether on the soccer field or at her practice, the author vows to start sharing responsibility.

As I was playing soccer recently, I felt a little bad. I felt responsible for the fact that our team was getting spanked big time. Then I looked around me. I imagined the goalie felt some responsibility as well. Probably every woman on my team felt a little bit like they hadn't covered their part, letting one of the opponents through to score a goal. 

This got me thinking about my sense of responsibility at home and at work. Last week, I was part of a rapid quality improvement project focusing on how women are informed of a breast biopsy positive for cancer. Surprisingly, despite the numerous specialists involved in her care - radiology, primary care, OB/GYN, surgery, oncology - no one group was uniformly responsible for this task. Sometimes, the woman wasn't told at all. In medicine, we tend to be hyper-vigilant, but gaps in care exist. Sometimes we overlap certain things to the point of excess only to have another area completely bare.

Our team's solution to the problem of delivering a breast cancer diagnosis in a timely, sensitive, and competent manner was to assign the task to a RN breast care coordinator. One of the major challenges to implementation will likely be physician buy-in. It is not often (at least in our system) that a nurse is the one giving a diagnosis of cancer. However, the more we looked at the issue and all the potential avenues that could lead to this diagnosis, we realized it was the solution that made the most sense. A situation in which I'm not the only team member responsible for this life-changing conversation.

It can be difficult to let go of some responsibility (control) at home as well. I am a mom. The fact that my husband is a stay-at-home dad (and a phenomenal one at that) does not erase this truth. Moms are responsible for making sure the kids' fingernails and hair are cut, that they have jeans that will fit them on the first day of school, and that they write a thank-you note for the birthday present they just received. Granted, these are just my examples, but while the details may be different in your family, the principle of mom-hood is that, ultimately, we are responsible. I think this is where a lot of mom guilt comes into play. When you are trying to be responsible for everything, you fail to use the other members of your team, and you take on a burden that is nearly impossible to bear.

So, on the soccer field, in my clinic, and at home, I am resolving to share my responsibility with the members of my team.

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