We had a major quality incident in June – at our home. It was 9 p.m. on a Wednesday night and we were heading home from Olive Garden after a nice dinner celebrating the last day of school. As my better half was reviewing the schedule for the following day, we realized we had no plan for childcare! We had assumed that our 17-year-old would be available and willing to perform older sisterly duties for a day – that is, keep her two younger brothers safe and fed and prevent a riot by keeping them separated for 10 hours.
But she reminded us that she had a full day commitment that Thursday and was not going to be home, and that she had texted us about this a week ago, and that we always ignored her texts, and that we ignored her in general. I regurgitated the unlimited breadsticks smeared with Alfredo sauce I had just savored, and immediately went into the BMT Medical Director mode. No harm had been done, yet. Amidst the eye rolls and “I told you so’s,” I reminded our team in the car that this was not about finding fault but to use this opportunity to come together as a team, problem solve and get better.
Fortunately, our nanny was available that day, but 11 a.m. was the earliest she could stop by. As soon as we got home, I and wife logged in to check our clinic schedules for the following day – her clinic schedule was bursting to its seams. Thankfully, it was a non-clinic day for me with a host of meetings and conference calls, but I had two followup ‘add-on’ patients in the morning. After a few texts and emails, I had it all sorted out – a colleague was available to see my patients and I had either rescheduled some meetings or changed them to a phone call. We capped the night with a family meeting where we reviewed the morning schedule and charted the time of my conference calls when the boys would be in solitary confinement with their iPads (on a side note, I calculated that Netflix is a very cost-effective nanny). I am working on a corrective action plan that I hope will impress FACT when they visit and inspect our program later in June.
Work-life balance and burnout have become increasingly relevant among clinicians, and we in the field of blood and marrow transplantation and cellular therapy are not immune. In fact, in a survey of nearly 1,000 hematopoietic cell transplantation professionals, Neumann et. al., found an overall burnout rate of 40% and it was associated with inadequate work-life balance. Remedies for reducing burnout and thereby promoting work-life balance have focused on systemic issues such as simplifying documentation and electronic medical record enhancements.
However, one aspect that needs more emphasis is the role your team plays in supporting you through moments of crises such as the one detailed above. Resiliency training does not help with unexpected events such as childcare plans falling through or sickness in self or family, but a supportive colleagues who can empathize and step up to help in such situations can go a long way in making you feel good about what you do.
The society has been busy in June. There are several meetings coming up soon, including the Clinical Research Training Course (CRTC) in July and the Clinical Education Conference (CEC) in September. The sessions for the TCT 2020 meetings is almost finalized and I can assure you that it will be among the best Tandem/TCT meeting ever with several new offerings and sessions. Most of us go to the TCT meetings to learn, connect and network, and the experience is fairly seamless and enjoyable. However, there is a dedicated and passionate team of ASTCT and CIBMTR staff who work tirelessly throughout the year under the guidance of our Scientific Organizing Committee to make this happen (shout out to our 2020 meeting co-chairs, Drs Katy Rezvani and Mary Flowers).
The other big thing for the month came from our Government Relations Committee – we submitted our comments to CMS’s IPPS. We continue to be concerned that inadequate Medicare reimbursement will threaten access to the highly innovative cell therapies that are in the commercial space and the ones that are in the pipeline. I want to emphasize that as a society we do not condone drug/CAR-T prices. At the end of the day, their costs have to be put in the context of long-term value that these therapies provide. But as we figure out the optimal value-cost-benefit equation, we continue to work with CMS and encourage them to work with the ASTCT to find creative solutions to ensure sufficient reimbursement in the meantime.
If you have not done so already, please do download/update the ASTCT app. It has been updated with our new "colors."
That’s all for June folks! We are still waiting for summer in Cleveland. July 1 is a time for new beginnings for many of trainees and junior faculty – hopefully some of them will bring more sunshine and hotter temperatures to the Rock and Roll capital of the world.