Ukulele Serenade for a Thankless Healthcare Job

The following is a guest blog post by CT Lin MD, CMIO at University of Colorado Health.

I just spent some time on the phone with an informatics colleague going through a particularly tough time with an EHR replacement and upgrade. Some bad things had happened at the organization: a major visionary physician leader had quit, a department chair had assumed control and was tightening the control on “physician productivity”. Furthermore, a major EHR upgrade had gone wrong resulting in a major multi-day outage and highlighting glaring gaps in “down-time procedures.” Morale was very low.

This physician informaticist was reflecting on their ability to make a difference in an incredibly challenging environment- “Am I still up for confronting all the challenges of this job?” This person pointed out that “decisions are made and I’m left holding the bag.” “Physicians are angry and I have no good news to tell them and no resources to do anything about it.”


When I asked the pointed question- “Is it time for you to quit?” The response was telling.

“Actually, even if they asked me to step down from this informatics position, I LOVE getting in there and solving complicated problems so much that I would probably still do this work. Even for free.”

This eloquent statement reflects the core drivers of an effective and valuable physician informaticist.

Friedman, in a recent New York Times article, talks about the triple acceleration: climate change, globalization, and technology acceleration.  These are upending our world, rewriting the rules, and causing us to re-evaluate everything we thought we knew.

Our informatics work in healthcare is very similar. The rules change all the time- leaders change, visions change, vendors and products are always changing. Informaticists are the nexus between IT and clinicians, and are often blamed for anything that goes wrong. True story, when the WannaCry virus struck and took out the server farms at our transcription vendor last year (for SEVERAL WEEKS, our physicians and surgeon could not dictate their notes), the rumor within our organization was “You know, I heard that CT Lin shut that down because he just wants us to TYPE in his #*$&#$’ing EHR.”

If only I was that powerful. We often deal with problems not of our own making, limited or non-existent resources, and a lot of ambiguity.  So, “What can I do?” Here is my advice after walking a mile in my colleague’s shoes.

  1. Being a physician informaticist (PI) is often a thankless job. The quiet work we do: creating collaboration, understanding both IT and healthcare deeply, we translate and often avert disasters (avoiding bad design in templates, order sets, automated tools) that only we can see. When it works, the response is “Of course it was going to work. It is so simple.” When it doesn’t work, everyone knows it was you, even if it wasn’t.
  2. Your value to the leadership of the organization becomes more apparent over time- stay the course. When the PI stands up and helps calm the masses, when the PI can send email broadcasts or go to meetings and explain WHAT happened, and more importantly WHY and what is going to be done about it, he/she is usually more clear than the technologists and can speak the medical language of clinicians and patients. Over time, his/her value grows from being clear, steadfast, and a calming influence. Maybe the executives start including him/her in higher level decisions because they remember that value.
  3. Your value to the front line physicians and nurses is also incalculable. One time, a physician presumed that “Oh, the EHR project is going terribly… see how CT was walking with his head down and with that frown. Bad news.” On the other hand, being clear and concise (even if you can’t fix it) and being transparent about what is happening now and why, allows the PI to be a beacon in a storm, and the go-to person for clarity. PI’s often become a valued representative for physician interests.

As we talked this week, I had flashbacks of my years on the front lines doing this work. Over time, these memories are less like PTSD attacks and more like valued battle scars that one shows off proudly.

Thank you to our physician informaticists and our many colleagues working to adopt new technology- this song is dedicated to YOU.

Dear Burned Out Colleague (to Dear Theodosia, from Hamilton, the musical)

About CT Lin
CT Lin is a technophile, father, husband, ukulele enthusiast, and practicing physician. Dr. Lin is the Chief Medical Information Officer at University of Colorado Health. He writes a weekly blog on informatics and physician leadership at  CT uses creative and memorable techniques to help his organization through change from ukulele parodies to Haiku poems.

About Atos Digital Health Solutions
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