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Harrison Reed, PA-C, practices emergency medicine in Las Vegas, NV.<\/p>\n
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<\/p><\/div>\u201cI hate to say it, but in this job it\u2019s better to be fast than good.\u201d<\/p>\n
And I hate to hear it. I hate that, as the years go by, it\u2019s a concept that seems to grow in popularity. I hate that the people saying it have been working much longer than me. I should respect them; they should be wiser. I hate what it says about our industry. I hate what it means for our future.<\/p>\n
I hate it.<\/p>\n
Now this is the part where you tell me that I don\u2019t understand because I am too young, too inexperienced. Of course, I should<\/em> shy away from fast. I\u2019m the new guy trying to tackle my second specialty in three years. Maybe I\u2019m just rationalizing my own plodding pace. After all, I\u2019m the writer who told you I was fresh off the zebra farm<\/a><\/u>, right?<\/p>\n But I understand the origins of the \u201cbetter fast than good\u201d mentality. I\u2019ve seen the crowded emergency departments and the packed ICUs. I know how long people wait for a primary care appointment or a specialist referral. I raged at delays while my own mother searched for a diagnosis.<\/p>\n In medicine, time is everything. But at some point we focused more on saving<\/em> time rather than how we spend it. We became so obsessed with being efficient that we\u2019ve stopped being effective.<\/p>\n No doubt, many areas of the healthcare system are overloaded. But maybe some of that strain is just a symptom of being fast rather than good. Maybe it\u2019s the reason some speed-focused hospitals still keep pneumonia patients days longer than the national average. Maybe it\u2019s the reason people make second and third trips to the emergency department when they don\u2019t understand their diagnosis or treatment plan. Maybe an extra 20 minutes of end-of-life discussion on the oncology ward would have saved a tearful family days in the ICU.<\/p>\n
![\"doctor_handshake\"](\"http:\/\/blogs.nejm.org\/frontlines-clinical-medicine\/wp-content\/uploads\/sites\/8\/2016\/01\/doctor_handshake-300x226.jpg\")
<\/a>Of course, like any professional should, I\u2019m getting faster. I\u2019ve got the numbers and the metrics to prove it. And I\u2019m sure someone behind a desk somewhere is pretty pleased with that. But I\u2019m not. For me, speed is a byproduct, a downstream result, a reward for striving to do things the right way each time.<\/p>\n