Category: Healthcare Mindset

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! 

Fear

Check this out. What you will see is a psychological self-examination, by the physician pictured above as a medical student in a far simpler time, of whether or not she experiences fear as the result of working in healthcare during the pandemic. Her answering in the affirmative caused the next level of analysis, i.e., a pondering as to what she is actually afraid of. The thought processes here are sort of fascinating. Interestingly, she is not afraid of the agonizing symptoms of COVID-19. She figures that one of her colleagues can straighten that out with appropriate medication.

She’s not even afraid of leaving her kids behind. She figures they would thrive anyway.  

Nope. What she is afraid of is “to be on this earth and not matter.” To be so incapacitated that she can’t accomplish anything. Her whole life she has been striving. Thus, her greatest fear “is to be on a ventilator in an ICU, and despite all my earthly efforts, die, and become a statistic, and never actually make my mark on the world or reach my full potential.”

Bottom Line. Since the beginning of the pandemic, I have always thought that any sentient human being working in healthcare has got to be scared silly to go to work every day. BUT. I must confess that up until this point, I had never given a thought to the whole gamut of things that they might be afraid of.  

I have now!!!

Hospital CEO’s Behaving Badly

Several posts ago, we discussed the non-physician CEO who was allowed to make the first incision on a surgical patient in his hospital. Both the CEO and the surgeon involved in this debacle wound up getting summarily fired. Wow!!!

Want to see another hospital CEO behaving badly? Check this out.  What you will see is the young CEO of a small hospital stealing narcotics for his personal use from the hospital pharmacy.  

Bottom Line. I alluded to this in the previous post, but let me say it again. Pardon the Psychologist in me coming out, but I have thought quite a bit  about the lot of MBA Hospital Administrators. Many articles have been written in recent years concerning the resentment and pushback that these poor guys and ladies encounter when they are seen as trying to tell the MD’s in their charge “how to practice medicine.” Increased efficiency and all of that.

Is this a stressful situation for many of them?  

You bet!

Empty Operating Rooms

I posted recently about the fact that patients are staying away in droves from seeking elective medical care during the COVID-19 pandemic. Here is some more quantitative fuel to pour on that fire. Check this out. What you will see are survey results indicating that 48% of respondents had either delayed medical care themselves or had a family member that had done so. The plot thickens. The survey also found that 11% of the care skippers had their condition worsen as a result. Reportedly, several of the medical specialties most affected by these shortfalls (e.g., Emergency Medicine and Cardiology) have had their professional organization issue patient communications urging patients to get the care that they need. 

Bottom Line. YEAH, BUT… I don’t know where these purported patient communications have been running, because I haven’t seen any of them. I have said it before and I will say it again. There needs to be substantial shout volume placed behind these communications. What we are seeing reported here are findings in the early months of the pandemic. If the same care avoidance continues throughout 2020, we are going to see a marked negative effect on the health of millions of Americans, and on the economic health of tens of thousands of physicians as well. 

This is silly. We need to make this stop!

Patient Compliance???

We have all heard, and marveled at, stories of “grapefruit sized” tumors being surgically excised from patients. But check this beauty out. What you will likely be amazed and horrified to read is the story of a woman, pictured above, who had a tumor of 132 pounds removed.  It was growing at 10 pounds a week and was quite likely to kill her within a couple of weeks if not removed. Every time I see a case like this, I would like to talk to the patient post -surgery and ask what the heck they were thinking that let them get into this state to begin with. I understand the defense mechanism of denial, but this is sort of over the top. Bottom Line. What does all of this have to do with the “patient compliance” title? Simple. Cases like this are a profound reminder that patients are not necessarily approaching their health care in a rational way. SO. We need to understand the headsets of patients that allow themselves to get into this state, and find out what we can learn from these cases that we can generalize to dealing with the population at large. 

Maximum Benefit Or Social Responsibility???

That is the question that our friend, “A Country Doctor,” poses in this important post. Picture a situation, a very real situation as it turns out, where the premium brand name pharmaceutical product is priced at $13 per day, and is b.i.d. The generic of a product in the same treatment area goes out the door for a whopping $.65 per day, and is once a day therapy. Which to prescribe? What makes this seeming no brainer a little more interesting is that the premium product has a 20% greater reduction of cardiovascular risks than does the generic. BUT. On an absolute basis the risk numbers are cardiovascular events of 10% and 12% respectively. Confused yet? Here’s the doctor’s question. Should he prescribe the more expensive, less convenient medication to obtain the maximum theoretical benefit or should he prescribe the far less expensive, more convenient product and ignore the difference in efficacy? Bottom Line. The doctor wisely uses the term “stewardship” to describe the appropriate basis for making this decision. Read his discussion of the different things that stewardship could mean in this case and ponder what you would do if you were the prescribing decision maker in this situation.  Thought question. How much do the efficacy and cost ratios need to change in order for you to make the opposite decision?

Simple Truths

In my ongoing search for bloggable material related to healthcare “mindsets,” I often come across simple truths mouthed by unusual sources. Here is one of those. The gentleman pictured above, Ayden Jacob, deals in “The Future of Medicine Through Bioengineering.” Translated, he writes about how technological development is influencing patient treatment. But my point today, drawn from one of his blog posts, has nothing to do with technology. Rather, it is a comment on Ayden’s thought about abolitionist Frederick Douglas’s notion, “It is easier to build strong children than to repair broken men.” As you will read, he gets to this quote by watching an incredibly rude resident interacting with a distraught family. Threatening them, boasting about his surgical experience which is more fantasy than truth and moving on to chuckle repeatedly over his Twitter feed. Ayden opines that this man is “broken,” as are so many doctors who have been brutalized by our system of medical education. I’ve often talked about the impact that physician “burnout” must be having on patient treatment. Here is a clear case thereof and, Ayden observes, far from isolated. Bottom Line. We have also often talked about Dr. Pamela Wible’s work dedicated to physician suicide understanding and prevention. God bless her, she is trying to fix broken men. Work that is much needed in today’s burned out physician population. BUT. How much better it would be to prevent burnout and suicide by establishing a medical education system that built strong children.