"We are all caregivers..."

There is a famous story that supposedly happened when President John F. Kennedy visited the National Aeronautics and Space Administration headquarters at Cape Canaveral, Florida (I have written about this story in a very early post, "Back to that Vision thing...NASA, cathedrals, and an automobile executive").  President Kennedy was walking around on a tour and introduced himself to a janitor that was mopping the floor.  The President asked the janitor what he did at NASA, and the janitor replied, "Mr. President, I am helping put a man on the moon!"


I've been thinking a lot about this story the past few days.  Academic medical centers are facing a lot of challenges.  Recall that most academic medical centers have a three-fold mission - clinical care (frequently both highly specialized, technology-dependent, and expensive clinical care for patients with complex or rare medical problems, as well as medical care for those with either no insurance or public insurance), education (teaching medical students, residents, and fellows), and research (both laboratory-based basic science research, as well as clinical research).  While the American health care system may not be idolized for its cost (we are the most expensive health care delivery system in the world), efficiency (there is a lot of waste in our system that adds to the often exorbitant costs associated with care delivery), or outcomes (we rank far below many other countries in disease-specific outcomes), our efforts at research and education have achieved far more success.  Unfortunately, we don't always work together in achieving our three-part mission.  Ask anyone who works at an academic medical center and they will tell you about the so-called "haves" and "have-nots" when it comes to certain disciplines and specialties.  They will also tell you, depending upon where they stand, that clinicians who provide care and generate the most revenue for the hospital are valued more than researchers, or that researchers that generate grant revenue are valued more than the clinicians.


When I think about all of these things, I can only wonder why we have to segment ourselves in this way?  In my mind, we are caregivers.  Clinical care, research, and education in an academic medical center is directed at one thing only - saving lives and improving outcomes.  I could also say that we are all researchers.  Some of my proudest moments as a physician have occurred when a colleague that I know and work closely with has been successful in coming up with some new discovery, getting a grant, or publishing a manuscript.  I know that the work I do as a clinician can help provide support so that he or she can have the necessary time to build a successful research program.  I am also proud of our medical students, residents, and fellows.  I have seen the future in their eyes, and I can honestly say that our future is bright.  I am proud that I have played a small role in their training and education, even if the majority of their training and education was provided by our educators.  In this light, we are all educators too.


It doesn't matter whether you are a physician, a nurse, or an allied health professional.  It doesn't matter if you are an administrator, a security guard, or even a janitor.  It doesn't matter whether you are a gifted clinician, researcher, or educator.  We are all here to make a difference in someone's life - either now or at some point in the future.  We are all caregivers.  We are all researchers.  And we are all educators.