Narrowing the Gap

Dr. Steve Carstensen challenges his sleep medicine colleagues to life-long learning. Sleep medicine is especially challenging as the volume of ‘what is known’ is constantly, and rapidly, expanding.

Dentists have been told since the first day of graduate school that learning is life-long, that their dental degree is only the beginning, and that keeping up with what is known is part of the professional’s commitment. Sleep medicine, which has come to be understood only within the current generation of medical doctors, researchers, teachers, and dentists, is especially challenging as the volume of ‘what is known’ is constantly, and rapidly, expanding.
Pankey Institute training used to emphasize ‘Narrowing the Gap Between What is Known and What is Practiced.’ I’ve always liked this phrase because it illustrates nicely the challenge we all willingly and, to varying degrees, enthusiastically, embrace. Facing our patients daily with the awesome responsibility of tailoring scientific knowledge to their clinical presentation and finding solutions for critical medical, social, and behavioral needs demands that we keep up with what is known and apply that to our work to narrow the gap.
It’s not enough to just go to class, to only read the journals, to confine yourself to increasing your treasure trove of details about medical practice. Education requires implementation to have value.
Fortunately, as soon as you start identifying sleepy patients in your practice or telling your colleagues that you’ve discovered an exciting new way to serve, you will be presented opportunities to use this knowledge. Your staff will look at you in the team meeting, confident that their leader will help them navigate new systems, new conversations, new job skills. Your patients will ask you about the importance of the 6 they just scored on the STOP-BANG or the 14 on the Epworth your hygienist handed them in your fresh screening protocol. They’ll bring in a sleep study to their next visit and ask you what it means, now that you’re a declared ‘expert’ – because they trust you more than they do the sleep doc they just met.
Ready for that? Some of you are gleefully embracing these opportunities, eagerly seeking the rewards that accompany solving clinical riddles posed by our patients and moving them along the path towards better health and happier social life. Others of you are stuck in the learning loop, overly impressed by ‘how much there is to know’ before beginning to provide solutions to your patients.
The gap is real. One side, what is known, is moving all the time – very rapidly in sleep medicine. Knowing more is not like piling books on a chair so eventually the cookie jar becomes within reach. The gap between what you know and what you put into practice can only be narrowed by action.
Apply your knowledge. Put into play something you learn from this issue of DSP, as soon as you read it.  Talk to a team member about an idea, solicit one from them, and make something happen. After it’s done, talk about it some more – think about the process, the outcome, the reward, the lesson learned. What you’ll do next time the same opportunity comes your way.
Repeat the process for another idea, something you learned or a conversation with a medical colleague. Involve your team and watch how they blossom in this exciting atmosphere of leadership, collaboration, and reward.
You’ll create a culture of narrowing the gap. Can you close it? No chance – that bank of knowledge is growing faster than you can keep up with and the individuality of our patients means no one ever precisely matches the case example. Our medical decision-making is the action that narrows the gap – forming bridges to the other side.  Making a difference. That’s the life of a professional. And it is spectacular.

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