The Craftsman Clinician

Below is a guest post from Garrett Chism, MBA, EMT-P. Garrett has been in EMS for 25 years. He currently works as a Paramedic for Denver Health and Adjunct Faculty for Metropolitan State University of Denver. I hope you enjoy his thoughts as much as I did. 

-Bill

Things I love: Hearing Garrison Keilor tell a story; the pianist carefully choosing the perfect note; the movement of a brush on canvas; the sound a perfectly sharpened hand plane makes on hardwood… And the moment a new clinician runs their perfect call and knows it. The smile and confidence they have at that moment is worth it all.

In my older age I have become slightly obsessed with craftsmanship. I spend a fair amount of time reading, watching, and listening to different forms of craftsmanship. Recently, I sat in the front of the ambulance and thought about what makes a craftsman? Do I, as a clinician, act as a craftsman?

Merriam-Webster defines craftsman as “a worker who practices a trade or handicraft; one who creates or performs with skill or dexterity especially in the manual arts.”

I find that definition to be inadequate. The difference between a craftsman and a dilettante amateur is the pursuit of perfection. As I ponder this I am preparing to teach a new employee. I have taught for most of my career. I used to think I was fairly decent at it; however, age has given me a clear lens to the mistakes of my male, egotistical youth. So as I prepare to teach again, I began to think, “What would a craftsman clinician do differently?” I ask myself how to pass on the experience of my chosen craft… not the drama, not the ego, not the inflated stories, but the really important lessons that others wiser than me have taught me. Here is my list of what makes the first cut. I hope you find this helpful, add on to it, and pass it on.

1. Be the patient’s advocate. This takes many forms, I am sure you've heard them before, be their advocate… many times you are the only one who is. The craftsman clinician makes all decisions based on this golden rule.

2. Communicate like a human being. Listen, don’t hear. Clinicians who are craftsman aren’t rapid firing questions at patients to get the quickest answer possible, only to be forgotten not ten seconds later. A craftsman clinician listens, with the intent to learn and understand. Talk to patients like they’re a friend or family member… because they are someone’s. 

3. Stop making assumptions. When I moved into a position in the hospital, I was amazed on how little I knew, how often EMS is wrong, and how much larger the patient experience is beyond the walls of the Emergency Department. I often say that even the best clinician can never be as good as the one that has been a patient before. Craftsman clinicians don’t pretend to know everything. Rather, they actively educate themselves on different areas of medicine with an open mind of what EMS can do to make the total patient experience better.

4. Focus only on the things that matter and spend lots of time perfecting them. Practice perfecting every detail of your craft. Hone a complete patient assessment, the perfectly executed treatment plan, the clear transition to the next clinician. 

5. Care. Beyond caring about your patient, care about the work you do. Care about your peers and students, as well. It’s great to practice medicine, but practice with the intent of improving every single time. Craftsman clinicians care so much about perfecting their craft that the end result is the best possible experience for a patient.

Craftsmanship takes time. It takes generations to develop. It takes constant pursuit of perfection in the tools, the education, the mentors… especially the mentors. Craftsmen dedicate their lives to their craft, love their craft, perfect their craft, and want nothing more than to pass that love on to the next generation.

Garrett Chism