Systems

So I have heard the greats talk about systems for so long but I didn't really get the full ramification until being a resident. The issue is that along with gathering data and making educated management decisions, I am responsible to make sure these decisions get carried out. If I want a patient to go for an abdominal CT, I can put in the orders and hope he magically gets there, but the reality is, if too much time goes by and the CT doesn't get done, I must bring him myself to radiology or find some other means.

The problem with systems is that they are dependent on people. You don't just make a decision and automatically it happens. There are many bottle necks in the system for many reasons. Every health care worker is in essence a potential bottle neck for the patients who have waited for what seems like forever for service.

As I understand things, the way to be a good resident is to know how to work the system. By now I should already be a great information gatherer. I make decisions in conjunction with attendings. The real trick to master at this point is how to mobilize the system.