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When is it Enough?

Are you satisfied? Is anyone satisfied? Where do you draw the line - in love, in wealth, in health, in achievement? So many of us don't know when to stop; it's never enough.

We see this in hospice. Hospice really should be about intimate end-of-life care but when the goals are wrong, when the goals are "corporate-type" goals of growing relentlessly, increasing revenue year after year, adding on more and more patients, the hospice will fail in its mission. It's amazing how many hospices fall prey to this. They may start off well-intentioned and grow, but the business leaders inevitably become dissatisfied with where they are, and push for more.

This is a particularly frustrating point. Leadership in medicine is often grossly ignorant of the real demands at hand, and can end up pushing an entity in a direction where it will exceed its ability to sustain itself. This is because leadership is often not medical, or medical enough, has not done the work or ascended the ladder, or has become too distant to really know what the work is. Since they dont understand the work, they don't value it, and therefore don't adequately support those who do it, which burns out staff.

But if you want good results in medicine, you need to support your employees first - yes, before patients. If you support your employees, it'll reflect itself in the care your patients get, which will ultimately literally pay off. This is because there is virtually no globally harder job than medicine. The grind of having to take full care of patients, be responsible for their well-being, of being on call, of having to work long shifts, of having to put ones safety and health on the line to take care of the sick day after day is only something those who have done the work understand. To work in medicine means to sacrifice on some level. Leadership that doesn't comprehend this point to its core, in order to protect its staff's well-being, will run its ship into the ground.

And this is where people have to ask the question, when is enough enough? How much money do you really need to have? How big do your profit margins need to be? How much do have to grow? Do you have to grow, or can you reach an ideal state and size and exist there in homeostasis? I would contend that we don't always need to grow, especially to the detriment of those and what supports us, that we can be selective in our growth - like with a garden - to have to output we want. I think the work-life balance, especially in hospice, where we absorb the pain and grief daily of our patients, is the most important thing. After all, this very quality of life we're trying to give our patients, is what sustains us all.


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