#OurTufts Features Richard Freeman

"Starting around when I was 10 years old, on weekends, my dad would sometimes take me on his hospital rounds. He was a nephrologist in the early days of artificial kidney treatments, at a time when there were far more patients in need of the treatment than there were dialysis machines to care for them. I saw from an early age the difficult decisions he faced—and the impact those decisions had on his patients and their families.

When it comes to decision-making, everyone talks about meaningful metrics. But meaningful to whom? I’ve spent my career as a transplant surgeon. With many more people who need transplants than there are organs available: how you do make fair and transparent policy to guide those decisions?

Those polices used to be developed by expert opinion of a group of doctors sitting in a room. In 1999, I chaired the national committee that centered patients’ data—not doctors’ opinions—in that decision-making. The metric we developed was based on a patient’s risk of dying while on the transplant waiting list. That example, based on objective, patient-centered data, drove the change that’s now the core of all organ transplantation policies worldwide. You induce change with metrics that motivate.

It's true that when you’re a surgeon and your patient starts bleeding, you don’t need feedback; you need to act. That’s how we’re trained. But most medicine isn't practiced in the OR; most of the time the patient's not bleeding. The model of the doctor in charge of every decision, right or wrong, doesn’t fly anymore.

Humility is a physician’s most important trait. You don’t know all the answers. In the hospital, respect what the nurse knows from having been at the patient's bedside more than you have been. Respect the pharmacist’s deep knowledge of drug interactions… the social workers, the behavioral health experts… Stay humble in getting input from your team. I think all of us who trained as doctors struggle with it. I’m still working on it, too."

—Richard Freeman, Vice Dean for Academic Affairs and Professor of Surgery. 

#OurTufts is a series of personal stories shared by members of the Tufts community [Photo Credit: Alonso Nichols]