September 20, 2009

Problem Solving

As brother recuperates in the hospital, we've been working on putting together his discharge plan. In doing so, I've found myself in several conversations with mid-level medical professionals who insist that things have to go exactly according to their prescribed plan.

They have no concept of deviation from their plan that would attain the same goals as the plan but would work better for the family.

They are very good at what they do. But they are used to being omnipotent. They control the drugs, the procedures, and the resources that the patients need. When they say no, the patient has no choice. They are not encouraged to think creatively, or to seek alternate solutions, and so their world is composed of many statements that sound like "either you do this, or there is failure."

Except, a family putting together a plan to take care of a quadriplegic may not have the exact resources and situation that their discharge plan considers must be in place. We are very committed to getting his needs met, but we cannot make it work according to their standard model. Getting them to understand this has been extremely frustrating. They consider our "that's not going to work for us" statements as "we want to fail" rather than "how can we find an alternate solution?"

Before going this process, I never appreciated just how creative being a lawyer is. Every day I work, I get to listen to people who can't agree, I try to understand the end goals, the real concerns, and then I get to think and to try to help them find solutions that address each of their needs in a way that everyone can live with.

This problem solving process is very similar to how engineers solve problems. Engineers go back to the basic principles of what they are trying to achieve and then think of the myriad ways they *might* be able to achieve it. I think, prior to this hospital experience, I assumed that the problem solving skills I regularly see deployed in the business world were similar to how medical professionals solved problems as well. It appears, from observation, that doctors still follow a process that is somewhat similar to the one I use every day. But, the majority of the folks you interact with during a typical day at the hospital are not doctors. And many of them are not empowered to seek solutions that have not been pre-approved, so those folks appear to be very uncomfortable brainstorming or exploring alternate options.

In fact, many of them are actually unable to accept that something on their checklist is completely unfeasible. It is fascinating to watch. When the checklist is cut off, so is their ability to do their job. They must seek senior approval for everything, so the process grinds to a halt.

In short, this hospital experience has made me very grateful for the creative aspects of my job.

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