Safeway Standard

The doc who I have worked with most so far in the clinic says that there are three levels of standards of care to which doctors can choose to adhere. The first and lowest standard is the "legal" standard (what do I have to do to not get sued). The next standard is the "professional" standard which is a much higher standard than the legal standard. But in small towns, like Valdez, the highest standard is the "Safeway" standard which is when doctors consider the fact that they will see their patients in the Safeway (only supermarket in town) and that they thus must do their absolute best because they will be held accountable and every time they see the patient in the grocery store they will be faced with it if they do not do their very best. I was thinking about this at the end of another very long day as I helped to suture the chin of a guy who had a three-inch long laceration that went down to the bone from some kind of metal chunk that flew of a pressurized valve into his chin. It is not that, as doctors, we don't always strive to do our best but it does add another level of pressure/incentive when your patients are your friends and neighbors.

It was another eventful day starting with a colonoscopy (during which I got to help drive the camera) and ending with suturing. In the middle I enjoyed more routine prenatal care, removal of a scalp mass, working up back pain, vertigo and innumerable other things. The doc I'm working with even considered doing an appendectomy today but it turned out not to be necessary. There was literally not a single dull moment.

And yet despite the immense workload that we faced today, the doc that I am working with impressed me so much with the fact that every time he was in the room with a patient he made it seem like they were the only patient that he had to see today. For instance, he spent twice as long as necessary with the soon-to-be parents marveling with them at their baby's ultrasound even though he had guy with a gaping chasm in his chin waiting in the ED. He makes small-talk with everyone and always seems genuinely engaged with his patients. I think it's the Safeway standard in action.