BY JAMIU BUSARI (@JOBUSAR)
Dave Laclé (LinkedIn)
Hospitalist at Horacio Oduber Hospital
Chair, Care Calamity Committee
Chair, Residents Committee HOH Academy
Member blood transfusion Committee, Medication Safety Committee and JCI accreditation steering Committee at Horacio Oduber Hospital
Country of Aruba
Dave Laclé MD, was born and raised on the beautiful island of Aruba. “After finishing high school in Aruba, I set out to study medicine at the Maastricht University in the Netherlands. It was the first time I had been to the Netherlands, and I was alone.” It is with these words that Dr. Dave Laclé, Hospitalist and chair of the residency training committee at Horacio Oduber Hospital, starts this interview.
A pioneer in hospital medicine
After obtaining his MD at Maastricht University in 2013 and finishing his training as a hospitalist at the University Medical Center, Groningen in the Netherlands, Dr. Laclé returned home in November 2016, to pioneer the introduction of hospital medicine in Aruba as one of the two hospitalists at HOH. Dave confides that very few Arubans get the opportunity to be a physician, so he consulted with the hospital board before choosing to train in “hospital medicine” to ensure his specialty would be a good fit for the hospital and his country. He knew he preferred to be a generalist than a super-specialist because he wanted to keep his expertise as broad as possible. Unlike the United States and Canada, hospitalists were unknown in the Netherlands and Aruba. In fact, Horacio Oduber Hospital is the only hospital in the region to have Hospital Medicine and two hospitalists in service. “I have always wanted to return to Aruba to help the island, he says, not only by providing care but also improving the quality and safety of service in the only hospital we have on the island.”
Dave’s journey as a CE began in 2016 when he started working in the hospital. Training opportunities are limited for Arubans, making it challenging to train as physicians – most have to travel to the Netherlands to do so. This means many choose to train in neighboring Latin American medical schools. Wanting to support his country, he made it his main objective to create a program enabling Latin American-trained residents to obtain recertification as European-trained physicians. With Dr. S. Jacobs, a fellow hospitalist, he set up a two-year residency transition program for Aruban residents who trained in Latin America, enabling them to work under supervision in HOH in preparation for recertification exams in the Netherlands. The first resident who participated in this program in 2017 is currently completing a cardiology residency in the Netherlands and is expected to return to work as a cardiologist on the island. Additionally, Dr. Laclé is also trained in quality improvement and patient safety within healthcare. He is the chairman of the Care Calamity Committee of the HOH, which oversees hospital-related complications and calamities and provides mitigatory measures to prevent and improve the quality of service offered.
“Never a dull moment”
Dave describes his daily activities, saying, “My work is very diverse and can change at any moment. I plan my tasks at the beginning of the day, but that can change at any second. I can start one-day supervising rounds and grand rounds, other days organizing multidisciplinary consultations, or another with meetings all day. For example, as chairman of the care calamity commission, chairman of the resident education committee, and many other committees I am part of. Next, I invest a lot of time advocating for Aruban residents aspiring to follow specialty training programs in the Netherlands. This diversity keeps me coming to work with a warm cup of coffee in my hand and a big smile on my face.”
He spreads his time across his clinical, teaching, and administrative activities, stating that he spends about 70% of his time in clinical practice, 20% on administrative work, 10% on teaching activities, and very little on educational research. He shares that clinical research is challenging on a small island like Aruba, the biggest problem being the lack of data (registration). Electronic patient records are a fairly new addition (2017/2018), and the data before this was challenging to obtain. This has resulted in additional challenges: in November 2019, the hospital’s electronic system was hacked, and much of the data was lost. The COVID-19 pandemic that ensued in 2020 did not help issues, as the main focus of the hospital and island was on patient care and mitigating the spread of the virus. Due to these challenges and more, efforts in HOH have recently been prioritized to providing care. However, steps are now being taken to shift the balance.
When asked if he faced any challenges due to the diverse nature of his work, Dr. Laclé responds that time was the most important factor: “I try to manage this by working at a fast pace (one that I can handle), making sure I don’t schedule everything at once, and being realistic about deadlines. My motto is “I would rather complete one thing for 100% and not take on more than leave work having done everything at 50%. So, I ensure I don’t have too much on my plate.” He also prioritizes spending time with family and having enough time for himself. He outlines the importance of work-life balance, particularly in preventing resentment towards your job. He finishes by saying “There is never a dull moment.”
Three tips for junior CEs: Be inclusive, create safe spaces and tailor your lessons to the student
- Inclusion is very important. A person’s background, ethnicity, sex, or where they graduated does and should not matter. Ensure everybody is included and gets the opportunity to become competent and certified health care professional based on the standards demanded by the institution.
- Create psychological safety. We cannot identify learning objectives without creating a safe environment where everybody can be truthful without fear of shame for making a mistake or not knowing something.
- Tailor clinical education to each person. For example, some might need more time, use different language, be more practical than theoretical, or the other way around. Instead of feedback, use debriefing.
The views and opinions expressed in this post are those of the interviewee and do not necessarily reflect the official policy or position of The Royal College of Physicians and Surgeons of Canada. For more details on our site disclaimers, please see our ‘About’ page