Doing things right

This is a picture of Aneurin Bevin, Founder of the NHS (60 years this week). I thought I would look at how my work practices and training for an ironman are similar and how they inform each other.



These last 10 days have been dominated by work with a a sequence of days on call (I lead a team of doctors delivering acute care for patients in a hospital) and a subsequent large patient workload which increases the demands on my weekly schedule (but luckily coincides with a reduction in hours of training- not bad on the planning front that). In addition I have been filling out paperwork to justify my pay and hopefully get me more; the key to this is a process called clinical governance which is essentially a philosphy of healthcare geared at doing things right.



Most people are clear what they want from a doctor; they want him to be polite and caring, knowledgeable, empathic, highly skilled dutiful and so on but above all have good results so they get better, especially when it comes to surgery. It is quite easy to appear to be all these things whilst actually not delivering the care patients need and likewise it is possible to exhibit none of these characteristics, at least to the incidental observer whilst actually delivering the highest quality care. The problem is how you determine whether a doctor has the desirable qualities. The process of CG if done correctly requires honest self appraisal, monitoring of you delivery of care across the year from many different perspectives (e.g. patients, colleagues, community etc) and participation in all the aspects that govern this such as audit of outcomes, attendance of meetings, further education all culminating in an annual status report where you go through the years work with a colleague summarise what was achieved and then set the goals for the coming year.


And it struck me that the parallels with training for ironman are all there. Successful racing starts with an honest appraisal of where you are starting from. It then requires the development of regular habits that if done correctly over a period of time will gradually reward you with improving performances. You need to perform regular assessments along the way (such as the odd time trial or race), and when you make mistakes look at what went wrong and learn lessons from it- and hopefully avoid making the same mistake next time. Overall you need to be honest with yourself about what you are doing and whether you are meeting your targets. It is this honesty that comes from racing at ironman: when you step out there it is easy for everyone to see how well you have performed. In my work this process is a lot less transparent but the ideals remain with me.



As I face my annual ironman appraisal by returning to IMA I wonder how honest have I been with my training this year: I felt my biking was going to be much better this year than last but IM Lanzarote was not terribly encouraging. If I dont meet my goals will I be discouraged- no I will respond by using the knowledge from this year to drive me forwards next year to try and get better both as an ironman and as a doctor.