I'm often asked what keeps programs from reaching their potential? Several factors, but one stands out.
A program can be successfully STARTED with less than 1.0 FTE - the challenge becomes in sustaining the program with such limited staffing. The shortage of palliative care specialists makes timely scaling of the program one of, if not the greatest, management challenges. Those that have been able to SUSTAIN the program with limited staffing have done so because they've effectively brought infrastructure (intellectual capital) to the program at the right time and in the right amount. Yet , as one might surmise, doing so demands management agility and acumen and, most precious of all, time. These are resources in short supply at most fledgling programs.
In future posts, we'll examine several other barriers to program growth, and how successful programs have surmounted those obstacles. Most of all, I'm curious to learn experiences of readers of this blog.
Why were physicians against smallpox variolation in the Middle Ages?
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From the Conversation with Tyler podcast with Sheilagh Ogilvie: [Ogilvie]:
Historically, there was another reason, which was the medical guilds — the
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