Looking out my office window, I usually see the neighbor’s cat sitting in the sun, this pesky Cardinal that wants nothing to do with me (other than divebombing the dogs), and of course, the fence. The black border that separates my yard and my neighbor. One side of the property line is mine; the other is not. Obviously, I’d never build a shed or cut down a tree beyond the black boundary. But that pesky little Cardinal – he flies across the boundary as though it doesn’t exist and that is completely acceptable.

That had me thinking – where are we creating borders instead of connection? Connection itself is crucial for fostering collaboration and improving outcomes. When the disconnections form, we find countless troublesome stories.

Too often, we operate in silos, unaware of the blind spots right in front of us.

I’ll start with a personal example. A friend had a Transient Ischemic Attack (TIA) a few years back. Unfortunately, it turned her life upside down in unexpected ways. The memory loss she experienced made managing her health incredibly difficult. She began seeing multiple specialists, each prescribing different medications, but no one was looking at the bigger picture. Before she realized it, she was on three medications that counteracted each other, worsening her symptoms instead of helping. It wasn’t intentional; she simply forgot the details, like what she was already taking or why. This clearly highlights how easy it is for patients, especially those dealing with cognitive challenges after a TIA, to fall into the trap of polypharmacy without proper support and coordination.

Polypharmacy—the use of multiple medications by a single patient—poses significant challenges in healthcare settings, particularly in small medical practices, nursing homes, and other care environments. While medications are vital for managing chronic conditions, the risks associated with polypharmacy, such as adverse drug interactions and diminished quality of life, can’t be ignored. These risks become even more pressing in light of statistics showing that nearly one in seven Americans use five or more prescription drugs regularly, with rates significantly higher among older adults. Such medication burdens can overwhelm patients, often leading to confusion, decreased adherence, and preventable complications. Addressing these issues isn’t just about safety—it’s about elevating the patient experience through eliminating the silos. 

What could deconstructing the siloed communication look like? Maybe it lies in regular medication reviews that identify potential drug interactions and empower patients to take an active role in their care. In the case of my friend, I found out her doctors were spending a minimal amount of time with her. There was no connection, no simplification of regimens, no shared decision-making, and limited education. She trusted the providers and adhered to what the individuals said, all while having no positive outcome. Needless to say, those doctors are no longer her doctors.

Just as healthcare providers need to look for those pesky blind spots, it’s glaringly obvious that any of us who have customers, clients, patients, users, need to be focused on the borders around us, ensuring they’re in service of those humans.

-L