How to stay current and clinically competent is an ongoing challenge for clinicians who cover a lot of clinical ground in one day. Most of us make valiant efforts to stay up to date, usually spurred on by inquisition, patients and recertification requirements – though not necessarily in that order.
For decades it has been postulated that giving clinicians information they need in a useful way can improve care, reduce cognitive load, error and fatigue. However there remains no reliable evidence to support this theory.
Apart from early training in medical school and specialty training later very little of our education takes place at the bedside. Separating theory from practice is just as unhealthy for practicing clinicians as it is for students and trainees.
Without some degree of personal involvement any informational services will fall short of the mark
The 21st century solution to this problem is mobile technology. Many resources are available to clinicians even at the point of care. The problem is that what is provided is incomplete. Without some degree of personal involvement to incorporate an understanding of the local clinical environment any informational services will fall short of the mark.
What is needed is a team of expert clinical translators and data interpreters. (It’s not that clinicians can’t do it, most just don’t have the time or resources to do it in an efficient way at the bedside.)
Clinicians are a valuable resource and if we enabled them to be renewable they could assist current practising clinicians and trainees to do more of what they do best: practise within clinical settings.
This is not an unreasonable suggestion given that the medical profession is losing clinicians by the bucket load. In the UK in 2010 voluntary early physician retirements rose by 72%.
Whether clinicians have retired because they have fulfilled their paid obligations to society or due to unsatisfactory work environments they should have the opportunity to contribute back to the system that now provides for their retirement.
Recycling clinicians is not new. Right now many retired clinicians are using their skills in non-patient contact ways like teaching ethics and physical examination. Some have become recognized as effective health system watchdogs.
A recycled clinician could look something like this: A retired cardiologist no longer wishes to be woken during the night to discuss a difficult admission but may be very happy to provide a critical review of the literature to support the continuing care of a patient during the ward round the following morning.
With a working lifetime of care in local illness environments retired clinicians are well placed to present relevant advances in a clinically and locally meaningful way. Much in the same way medical students and trainees do, but with much more relevance to clinical practice and maturity.
Retired clinicians have the skills set to collate and synthesize the cornucopia of information and help their practicing colleagues integrate this knowledge. This is already happening, to some degree in continuing professional development activities but not yet at the coalface of individual clinical care where its sorely needed.