Category: Health Professionals

Neurosurgery Meets Cosmetology

Check this out. What you will see is a story of a male Neurosurgeon being taught by some of his female staff the importance of a patient’s hair after surgery. Not just a water and alcohol rinse. Nope. Using a cosmetically elegant shampoo and conditioner! 

The benefit to the patient, he learned, is in realizing that the surgical team had helped her to take the first step back toward human normalcy immediately after the dehumanizing process of having her head opened up to remove a tumor. AND. An unintended consequence was that it also made the OR staff feel more human in the process. 

Bottom Line. Amazing how little dollops of civility can enhance the healthcare experience! 

Cannabis M.D.

Check this out. What you will be led to is the web presence of Jill Becker, M.D.  Trained in Ob/Gyn, Master’s Degree in counseling psychology, ordained Minister, etc.  BUT. Her main claim to fame is that she has extensively studied the use of cannabis used to deal with a large variety of medical problems. She will “work with your care team” to figure out the right cannabis program to cure what ails you. AND. Talk about a practice that is perfect for using telemedicine! She can work with patients nationwide using telemedicine platforms and can also help patients avoid any stigma that might accrue to being seen sitting in her waiting room. 

Bottom Line. Got me to wondering. How many other doctors have figured out this schtick??? Do the Google search and roam around like I did and you will know what I know. LOTS!!! All doing it via telemedicine.

Smart. I can see this specialization filling a real and important need that many (most?) doctors wouldn’t touch with a ten-foot pole!

Multifactorial Obesity

Check this out. What you will see is a reminder to physicians of the variety of psychological, social, and environmental factors that cannot only contribute to patients developing obesity, but as importantly, to their failure to comply with a treatment plan. 

And the explanation here is very well worded. The factors listed above don’t, at the most fundamental level, really cause obesity and treatment failure. Rather, they “…can trigger existing genetic substrates to promote obesity.” That’s different. Evolutionary Psychology (Go read this book!) teaches us that thousands of years ago, our ancestors on the savannah who learned to “calorie pack” were more likely to survive in a food-scarce environment, and thus more likely to pass those genes down to us today. When triggered, the behavior caused by these genes can cause obesity that is extremely unhealthy and difficult to modify.

Bottom Line. As I continue to ply my trade of marketing research, I have become increasingly convinced of the importance of learning to understand the layers of what I call the Behavior Pyramid. For example, most pharmaceutical marketing research focuses on physician prescribing “decisions.” But very few behaviors are actually based on decisions. Dig a little deeper, and you will find that most behavior is the result of habits. Look one more layer down, as in obesity, and you will find the impact of genetics.

Yup. Understanding these layers is important to physicians treating obesity, and to those of us who study these doctors!

Are Physical Exams Obsolete?

Sometimes! Check this out. What you will see is a post by our friend, The Country Doctor, who argues that such examinations are often conducted without a good reason.  and perfunctory. As evidence, he offers the successful journey that most physicians made into telemedicine during the COVID-19 pandemic, successfully treating patients without laying eyes or hands on them. 

BUT. The conversations I have been having with physicians for my ongoing On Doctors’ MindsSM project have clearly indicated to me that many of them feel otherwise. For them, telemedicine was a necessary, temporary adaptation to permit their practices to go on rather than being put under, in terms of both patient care and finances, by the coronavirus.  Now that offices have reopened to personal visits, telemedicine is being relegated to extremely limited use, if any. Doctors report that they need to observe their patients to get the full picture of what is going on. Specialists in fields from cardiology to neurology have specific evaluations that they want to make, and they have to be done in person.

But is the same thing true for PCPs in a “routine” office visit? A brief story. When my wife and I moved to Hilton Head Island almost a decade ago, we promptly joined the concierge practice of what we were told (and it is true!) was the best Internist in Beaufort County. On my wife’s first visit, the physician laid her hands on my wife’s throat and “felt something.” Scroll forward and her cancerous thyroid was summarily removed. A good “routine” physical exam? Damn straight!

Bottom Line. I get the Country Doctor’s point.  Sometimes physical exams look a lot like “going through the motions” for no reason whatsoever.  BUT. To catch the unanticipated, as well as to build patient relationships, they are probably about as far from obsolete as they could possibly be!!!

Emotional Labor

Check this out. Don’t study this article in too much depth. It will simply give you a headache. BUT. There are a few key take-aways.

First is the definition of emotional labor. Lots of different words can be applied here, but the concept is a simple and important one. That is, having to pretend that you are experiencing an emotion that you are not, or that you are not reacting emotionally to a set of circumstances that would normally cause an emotional reaction, takes work.  

Such play acting can occur at the shallow level, where you only need to convince those around you that you are cool with a situation, or at a deeper level where you actually have to convince yourself that you are all good with what is going on around you.  

Bottom Line. Hopefully, reading the above has gotten you to thinking. Wow! I bet that this kind of labor can get to be exhausting after a while. It might even cause burnout. Or worse.  

Now think about how much emotional labor front line health care workers have to put forth every day. Especially during a pandemic! Little wonder that the combination of their physical exhaustion and their emotional exhaustion is taking its toll!!!

Doximity’s 2020 Physician Compensation Survey

Check this out. What you will see are the results of Doximity’s Physician Compensation Survey. The results are expertly sliced and diced a zillion different ways, so I will just get the heck out of the way, let you examine this report and draw your own conclusions.

Mine? Not surprisingly, doctors who “cut” for a living continue to make more money than those who don’t. I guess that makes sense.

AND. Females physicians continue to make less money than male physicians. A lot less. I refuse to launch into the old arguments as to the reasons that might be the case, e.g. women balancing career and family. BUT. I know this still doesn’t make sense.  

Bottom Line. Overall, this survey tells us that physician income has increased at 1.5% in this year’s report. While that is lower than the reported inflation rate, it is still not nearly as bad an outcome as I would have predicted based on all of the articles I have been reading about patients staying away from doctors’ offices and surgical centers in droves as a result of the pandemic.  

What will we see in 2021? Likely more of the same!

Déjà vu All Over Again!!!

Or should I say plus “plus ca change, plus c’est meme chose.” Either works in this case. Check this out.

What have I seen before and am seeing here yet again? Most importantly and peculiarly, the report that the struggle to determine the appropriate role of NP’s and PA’s continues. On one side, we see the “mid-level professionals” (I never really understood exactly what that term means!) arguing that they should be able to deliver primary care without physician supervision. As described in this piece, there are some bizarre permutations of “supervision” written into some state laws, like a physician has to be “within so many miles” or agree to do “so many chart reviews.”  

On the other side, we see the AAFP staunchly defending what they see as the unique role of the Primary Care Physician, and the purely ancillary role of the other HCP’s.

The results of this struggle are far from trivial, since there are about 450,000 NP’s and PA’s combined and yes, that are a heck of a lot more than there are FP’s.  

Important to note here is this article’s reporting that, very understandably, the COVID-19 pandemic has caused the legislatures in several of the hardest hit states to loosen the supervisory constraints on the “paraprofessionals” (another one of my least favorite terms!) Will these changes remain in place after the pandemic?

Two other points very quickly. In this article, we see the lament that NP’s and PA’s don’t feel that they are getting the appropriate amount of attention from pharmaceutical marketers. Really? Most of my clients started to include them in their outreach years ago. 

Finally, I was fascinated to see that during the pandemic, Pharmaceutical Sales Representatives are now having food delivered to practices for consumption while participating in Zoom drug presentations. That one got me to thinking about the fact that, although the pandemic has been a challenge to PSR’s, it has also made them more efficient. No longer are they stopping at the deli to pick up the goodies, traveling miles to the office and sitting and waiting. And waiting!!!

Bottom Line. In terms of the role of the PA and NP, you would think all of this would have been resolved years ago. BUT. This is what happens when you have relatively uninformed legislators in 50 different States determining the roles of medical professionals. 

As to pharmaceutical companies marketing to NP’s and PA’s, I think they are!

Finally, I was around years ago when PSR’s started to deliver food to doctors’ offices to garner their attention, and now we see the new, pandemic-responsive permutation of that behavior. Like I said, it’s déjà vu all over again!!!

What Really Happened At Elmhurst Hospital???

Check this out. What you will see is our old buddy, ZDOGGMD, “debunking” a YouTube video. Scary stuff. Turns out that an antivaxxer, Covid-denying RN traveled from FL to do front line duty and collect hazardous duty pay at Elmhurst in Queens. The “epicenter of the epicenter” of the pandemic. BTW, she is NOT a trained CCU nurse. She then proceeds to make a bogus documentary, where she films front line workers, without their knowledge, at their weakest of moments. She calls them murderers, motivated only by money. Scarily, this video (I am NOT recommending that you watch it!) has had over 100,000 views!

Actually, the number of views is not the scary part. The scary part is the comments from the viewers. Really insightful thoughts like “this video demonstrates the need for alternative medicine,” and “Vitamin C works just fine for treating COVID.”

Bottom Line. ZDOGG is rightfully incensed and concerned that viewers will take the contents of this video at face value. A massive disservice to the brave medical professionals on the front line, and disconcerting to COVID patients and their families.  It is obviously a very good thing that he “debunked” it!

Murphy’s Law Applied To The ER

No heavy topic today. Just a little humor.  Check this out.  What you will see is an ER Doc’s recounting all of the different ways in which Murphy’s law can bedevil an Emergency Room physician. 68 different ways that can happen, in fact.

If you want to have some fun and have a couple minutes to spare, try looking for commonalities in these 68 manifestations of Murphy’s Law. How many have to do with risk of lawsuits? How many have to do with bodily fluids? Etc. 

Bottom Line. It must be a hoot to work in a setting where such happenings can simultaneously bring a little humor and cause delays that can be dangerous.

Please pass the cold pizza!        

The Sound of Silence

Check this out. What you will find is NOT the lyrics to the old Simon and Garfunkel song. What you WILL find is a blog post by a physician. In this post, he identifies the significant pressure that is often imposed on physicians and other healthcare professionals to keep their mouths shut. NOT to talk about mental health problems in ER’s. And very specifically, NOT to talk about the lack of PPE for medical professionals and other problems encountered during the Covid-19 pandemic.  

Bottom Line. The message here is clear. The truth, and people, both die in silence. We need to make sure that doesn’t happen!