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The Adequacy League

12/2/2013

2 Comments

 
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I haven't written much about parenting, because most of it is hard and boring. Like maintaining health, either as a doctor or a patient, it's usually a slog, requiring wellsprings of confidence to remain sure that what one is doing in the moment will have some measurable impact down the line. To that end, I have decided to found an organization to inspire such confidence, while establishing standards that can make most of us - the average parents, the pretty-good providers - feel supported in the slog. It is called the Adequacy League, and will have at least two arms, one for parents, one for physicians and patients.

The League of Adequate Parenting will emphasize that most of us who bellyache about child-rearing, and fear that we are not doing well enough, are actually doing just fine given our circumstances. This means, of course, that if we are parenting in resource-rich circumstances, we should appreciate that fact: our adequacy is not likely to be the same as that achievable under other circumstances.

Similarly, the Adequate Doctors-and-Patients' Union recognizes - by charter! - that there is a tension to medicine. On the one hand, much of what ails us gets better with time, and we ought not to interfere with that. But, on the other hand, we want to actively interfere in a great many conditions for which there is no "natural" cure. Adequacy means neither interfering without exception on principle nor refusing to intervene on the basis of some misguided alliance with "nature." Neither doing too much nor too little, and not looking over one's shoulder continuously at the latest study. The adequate doctor or patient can be satisfied with her efforts toward health even as she knows she is not perfect.

Adequacy does not mean complacency, but the ability to take stock of our current limitations, appreciating all we are managing to do.

Excellence can be quantified, sure, and we should all aspire to it. Poor performance can be avoided as well with the help of keen analysis. But neither striving for excellence nor avoiding error and harm can get us through a weekday morning, a whiny toddler, a chronic illness, a day full of things-to-do and people with quite legitimate demands whom we need to serve. Sustaining a notion of adequacy is key. The Adequacy League recognizes this. Though it presents no awards, reimburses no one for travel expenses, and has no meetings, it will exist, quietly, wherever you are, as long as you need it.


2 Comments
Carolyn Thomas link
12/9/2013 06:49:31 am

Thanks, Dr. B. I have decided to submit my application herewith for membership in the Adequacy League.

Just recently, I was thinking along the same lines when it comes to daily exercise. I have a little calendar in my bathroom cabinet, for example, upon which I put a shiny sparkly sticker for each day that I achieve my goal of one hour of exercise. But as a heart patient with ongoing cardiac issues, there are some days when I'm barely able to walk down to our local village and back. No stickers for that short and slow shuffle! But in keeping with your Adequacy mission, those are actually the days when I most deserve a shiny sparkly sticker - for just putting on my shoes and heading out the door when I'd really much rather just stay in bed with the covers pulled over my head.

So now I reward myself for those days when I can put in a good hour on a brisk walk or a gym workout (a great day!) but also for those days when I can barely drag myself out the door (an adequate day!)

Reply
Zack Berger link
12/9/2013 08:54:24 pm

Thanks! As you undoubtedly have figured out, the minute you consider becoming a member of the Adequacy League, you automatically become a member. So congratulations!

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    The author of Talking To Your Doctor and Making Sense of Medicine blogs about the books, shared decision making, doctor-patient communication, and the redeemable imperfections of healthcare.

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