On survival mode

As you’ve probably noticed, public health, like so many other sectors, is operating in an environment of sequestration capped off with a perpetually looming government shutdown.  We can feel the breeze as the money gets sucked out of our budgets.  We’re always hearing (and sometimes participating in) the never-ending refrain of “we’re being asked to do more with less.”  And we are.  The grant applications get longer, the expectations inch higher, and the lists of deliverables keep growing.  Our programs are always on the verge of taking that final funding hit that will do us in – and probably because of something totally out of our control.  Each of us is teetering on the edge of extinction.

We’re tired.  Collectively.  All of us.  Except for those of us who are too new to know to be tired, and even then, it only takes a couple of months.  Survival mode will do that to you.  But from tired, it’s a brief ride to short-sighted and lazy.  We forget about the big picture, and we focus instead on the ninety bajillion things we need to do to stay funded.

In short, we can’t see the forest for the trees, and “public health” has turned into “program health.”  Here’s an important reminder:  it’s not about you.  It’s not about your program.  It’s about the people we serve.  We can’t serve the people and our programs (or ourselves) at the same time.

Take a step back from the metrics, and think about why they’re there in the first place.  Think about universal goals you’re really shooting for.  They’re there somewhere – otherwise it would just be healthcare, not public health.  There’s a broader system-level purpose for every single criterion that you’re measured on.  Even the stupid ones.

Once you’ve got the vision, the metrics fall into their rightful places as stepping stones to wherever you’re trying to go.  It’s not about checking boxes.  It’s about doing what you need to do in order to actually help people.  It gets a lot easier when you remove yourself and adjust your framework.  And sometimes that’s all you need to be better at your job.

Well, that, and probably a nap.

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