Perfection is worth the effort

December 4th, 2019 by Nick Jacobs Leave a reply »


At age 21, I learned a significant lesson in both humility and reality. As a musician in a pit orchestra for a very complicated musical, my job was to play an extremely difficult trumpet part perfectly. This show required every ounce of musical training, knowledge, skill, coordination and endurance I had.

After a nearly 100% flawless performance, and an above-average performance from the actors, the show ended, and the audience applauded generously in appreciation. When we gathered together after the show, all of the praise and acknowledgement of skill and talent was directed toward the actors. At first I was confused and then a little angry that not one attendee congratulated the pit musicians for their almost flawless performance, not even my own parents.

That’s when it hit me. Similar to my orchestra playing friends, but completely different from my jazz and pop musician friends, my job involved one thing only that day: perfection. Those 10,000 hours I spent practicing in my room, in practice rooms and in orchestras, bands and ensembles, were all directed toward a perfect performance. Not unlike the job of an airline pilot or a racing pit crew, it’s only when things are not perfect that you’re noticed.

Of course, that same thing was not the case when I played in lounges and clubs, but when I was hired to perform symphonic work, ice shows and shows for Disney or for other performing groups and stars, it was also about perfection. In fact, if you missed even a few important notes or  entrances in a virtual sea of notes and music, you could be fired on the spot for those minor misses.

Let’s turn our attention to health care. I’ve written about medical errors. They are a major cause of death and suffering in the United States, and I have personally experienced several incidents over the years.

It hit me today that the same rules that are applied to musicians, racing pit crews and pilots might also be directed toward the staff and teams of performers employed in our health centers and hospitals. The phrase “Close enough for jazz” definitely should not apply to medical care.

I’m not sure which personality profiles should be married to which job descriptions, but if you’ve ever spent significant time with a pharmacist, it’s pretty clear they have been inculcated with the perfection gene, and collateral damage is not in their vernacular.

On the other side of that coin, Monday mornings were eye-opening times for me in the health care CEO seat as I’d review and sign off on the recorded medical errors that could lead to eventual lawsuits or malpractice claims, even though our hospital had the lowest rate of these types of incidents of any of our peer hospitals and one of the lowest rates of error in the United States.

Let’s be clear, perfection is not always something we should strive for in every aspect of life. It can make us crazy. In fact, I love life’s imperfections, but not when it comes to someone who is cutting me open or medicating me.

What can we do to ignite our perfection gene, and how do we instill that propensity to be perfect in the right people for the right jobs? How do we create more Top Guns?

Practice works, and not unlike those musicians or pilots who sit in rehearsals and simulation labs for hours at a time, every health system should require the same.

Fifteen years ago, I performed brain surgery on a human simulation dummy, and it felt very real when I applied that scalpel to the skin and hit the skull bone beneath. It certainly got my attention.

It’s my belief we can reduce deaths from unnecessary medical accidents by building in more simulation practice to the process, by requiring periodic testing to determine skill levels, and then reassigning personnel appropriately.

Let’s stop burying our mistakes.


1 comment

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