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Student Voices: What happens when change moves too fast?


Laura Palmer is a third year medical student at Texas Tech University. While she's all for change, she cautions about what can happen when the pace of that change may be too fast for students. 

Host: We're broadcasting live at the AAMC in Baltimore, 2015. And this year's conversation is about change. What needs to change in health care? And I know there's a ton of things, but we're asking each person what specific thing is on their mind right now.

Announcer: Asking questions, seeking solutions, Algorithms for Innovation. Live from Baltimore at the AAMC 2015.

Palmer: Hi, my name is Laura Palmer. I'm a third year medical student at Texas Tech, Paul L Foster School of Medicine in El Paso, Texas.

Host: Change in health care, it's inevitable, it's what we're talking about here at the AAMC because there are a lot of things that do need to change. Laura, what is something in health care that you feel needs to change?

Palmer: One of the things I've noticed though is I feel like these changes are coming too fast. To where making change after change, we're not really getting a chance to see that change out, or to see the outcomes of that change. Or even to be able to master that change before the next change is coming. And people have to kind of start all over again.

I kind of equate it, I did Teach for America, so I was a teacher, your first year of teaching, it's a really high learning curve and then after years of experience, you start to master it and you become a mastery teacher. And I kind of see it the same way in health care, is that you have a high learning curve once that change gets implemented, but then you begin to master that change, and actually make more a difference, more of an impact. You can see the outcomes, and then obviously evaluate it and see if it's worth keeping or worth changing. But, I think we need to give it a chance to work out.

Host: Are there some particular changes that you're seeing that you think we do need to slow down on? Like a specific example of that?

Palmer: I think at a microscopic level at schools, even curriculum changes where from one class to the next, obviously you're going to be having differences of opinion, but if you keep kind of flip-flopping back and forth, that might not necessarily be an effective way to enact change at your school.

And then even more on a macroscopic level, I think the issue also comes in with partisanship where people are working more against each other than with each other. And so you have that back and forth change with a change in parties and everything like that where, like I said, it's the quick back and forth change instead of the steadfast, longitudinal change, I think would really make a difference.

Host: So too much change. We're changing too many things, too fast. Is that fair?

Palmer: Yeah.

Host: That's your opinion on that?

Palmer: Right.

Host: Do you feel the other med students share your same feeling because my feeling after talking to med students is, no. They're all for let's mix things up.

Palmer: Right. I think it just depends on if you've seen over time that something's not working, definitely you need to make that change. We're seeing that problem with GME education where there are more and more medical schools, more and more students graduating but not more and more residency spots. And so that's a change that medical students are passionate about, that we want to see that change.

But then again, there are other things, just in general with health care or that's more hospital specific where if you're kind of changing back and forth, people are confused and they aren't able to effectively carry out the mission of what we're supposed to be doing.

Host: So slow down a little bit?

Palmer: Slow down and just let people master that, and then evaluate it, see the outcome, see if it's working or not before . . . I think people get excited and that's good, but you want to kind of reign that in and kind of focus on mastering what we can handle instead of, I think people in life in general, spread themselves too thin. And I think that's evident in health care, as well, is that we're trying to do so many things at once, and we're doing them all okay. But if we can do a few things really well and see them out, I think that'd be much more powerful and help our patient population.

Host: So pick a couple of priorities and see them through and go with it? And then pick a couple of others?

Palmer: Yeah, see them through and once you get that good foundation, then you can start looking at other things and start making other smaller changes. But unless, you have that foundation that's set where everyone's on that same page, everyone's working for the same mission, it's kind of like you're just running in circles.

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