Category: Healthcare Providers

Forest Fires and Healthcare

Remember a few weeks ago when I posted on the challenges that face hospitals in my home state of SC (Let alone FL!!!) when a hurricane threatens? And reported that researchers are actually gathering statistics to provide hospital decision makers with guidance as to the safest way to proceed?                        

Check this out.  What we see here is another permutation of the same issue.  What the heck does a hospital administrator do when a wildfire threatens her institution? Or, better yet, when the electric utility in her institution’s area announces that they are going to cut power to the area for an indefinite period of time for safety reasons?

What we learn here is that virtually no hospital in CA can afford to have generators large enough to permit them to conduct business as usual for an indefinite period of time. For power outages, the question here is not the hurricane-esque question of evacuate/don’t evacuate. The question here is what functions are most critical to keep running, and what do we do about the functions we are going to have to shut down???

Bottom Line. If there is a light at the end of this tunnel, it would seem to be in this article’s report that hospitals are starting to form strategic plans and do simulations against all such eventualities. Hopefully, guiding principles will evolve that will provide the next generation of hospital administrators with a better understanding of what to do when their power company turns out the lights!

Feelings!!!

We spend a lot of time here talking about “stuff.” About physician burnout due to crippling administrative pressures, moves by the Fed’s to import drugs into the U.S. to lower costs, etc. Today is different.  Please take a look at this piece. (Today, for reasons that you will see when you got to that URL, I couldn’t just grunt “Check this out.”)

What you will get is an inside look at what happens to a hospital staff when four children die in their ER, on the same night, as the result of a house fire. They did everything that they could, and it wasn’t enough. We often think about ER doc’s as being steeled against the emotional repercussions of patients dying in their unit. But not this time. Not this many lives. Not such young lives.  

Bottom Line. What you see is a description of an event that was described as being “life changing” for all of the staff. I am sure it was.  

As was so well synopsized by quotes in this piece:

“The death of a child is the single most traumatic event in medicine. To lose a child is to lose a piece of yourself.”

And:

“There is no foot too small that it cannot leave an imprint on this world.”          

Reading this piece several times over reminded me of just how amazing these people are. The ones we think of as just being “customers.” As “prescribing decision makers.”  

Nah!  These are feeling professionals who can go through an experience like this and get up and go to work the next day. When we interact with them, let’s try to keep that in mind and give them the credit and respect they deserve!

It’s Not Just Doctors And It’s Not Just Burnout!!!

Check this out. What you will see is a piece that starts off by reporting a death by suicide. Not of a doctor. Of a nurse. Not because of burnout. Because of bullying. But this is not just about one case. The article also notes that nurses are 23% more likely to commit suicide than are non-nurse females. AND. Both doctors and nurses are, not surprisingly, “better” at taking a suicide to completion than are members of the lay public. The plot thickens. A survey of 1,700 healthcare employees questioned them as to whether, if they saw an act of bullying in the workplace, they would they report it. Here’s the kicker. 10%, yes a measly 10%, said they would. Yup. 90% said they would stay silent. Various reasons for silence were offered, most of which boiled down to fear of reprisal. Bottom Line. SO. Like the title above announces, it is not just doctors that have problems in the healthcare workplace. And bullying needs to be added to burnout as a cause of these problems.  Think any of this might have an impact on HCP Mindset? On how doctors, nurses, etc.  treat their patients? On how willing, or even able,  they are to pay attention to our promotional messages? I’m going with YES on all of the above! Do you have any ideas, suggestions, or comments after reading this post? If so, stop by and leave a comment on the blog!

COPS AND DOCS???

Screen Shot 2017-09-19 at 9.00.02 AM We have talked several times recently about the risks that health care practitioners face in the workplace. Violence at the hands of patients and their friends and relatives. So, I found this article to be of interest for two reasons. First, it specifically reports that there is more workplace violence in healthcare than there is in any other field except law enforcement. Good Grief!!! Second, the article provides specific guidelines on what HCP’s can do to protect themselves in their workplace. Clever interventions like refusing to prescribe opioids. Common sense interventions like knowing if a patient has a history of violence before you enter the treatment room. Bottom Line. As I stand back and look at the themes that I typically deal with in this blog, I believe that many of them are starting to fit together. I am thinking that it doesn’t take a rocket scientist to see the relationship between the posts on physician burnout and suicide and those on violence against healthcare practitioners! 

Follow Up to A Debacle

Screen Shot 2017-09-09 at 7.20.28 PM Check out this article. What you will see is a story of an announcement by the hospital in Salt Lake City that employs the RN who was arrested in July for refusing to draw blood from an unconscious patient for the police to use as evidence. The patient had not been arrested or charged. With anything! We talked about her scandalous arrest last week. This week, the hospital announced that police will no longer be able to be in direct contact with medical professionals involved in patient care in their institution. Period. Bottom Line. This is an unfortunate but necessary step, as the hospital’s CEO proclaimed, to make sure that such a travesty never happens again. At least not under their roof. Apparently, the body cam worn by the cop, purchased at no small expense by the SLCPD to make sure that these kinds of things don’t happen, was not enough to avoid the horrific scene. It just recorded it! Oh, and the irony? The truck driver/patient is an active member of the auxiliary police force in his home town. Yup, he is a cop!  When violence against HCP’s is wreaked by criminals and police alike, we can expect to see all kinds of extra layers of protection being conjured up. Wonder what we will see next?

Not Funny!!!

ZDogg You know ZDOGGMD. I’ve frequently shared his videos, which display his rapping style used to communicate important medical messages. Typically, they are both profound and humorous. But this time there is no humor. The “incident” that ZDOGG is reporting here, in narrative rather than rapping style, is the recent story of a nurse who was raped at gunpoint by an inmate at the hospital at which she worked. The video lasts 20 minutes. Spend the time to watch it! ZDOGG makes several key points here. First, he believes that people have to understand that healthcare practitioners are on the front lines in more ways than one. They often deal with volatile people in volatile situations. We need to understand this. For example, in my home state of South Carolina, one of the places where the holder of a Concealed Carry Weapon (CCW) permit is not allowed to carry a gun is anyplace where “healthcare is being delivered.” I often wondered why. This piece gives me a better understanding of this exclusion. Second, he proposes that healthcare institutions must do everything in their power to protect their practitioners. Whether or not that was done at the hospital at which this attack occurred is now the subject of a civil suit filed by the two nurses who were involved. Finally, he requests that other healthcare practitioners reach out to show support for those who actually do become victims of violence in the workplace. Bottom Line. All of that sounds right! Think about it!!!

Doctor???

Health Care Blog We have previously written, probably ad nauseam at this point, about the raging battles in many healthcare fields concerning the rights and roles of “care extenders.” Dental Therapists, Physician Assistants, Nurse Practitioners, etc. BUT. Here is an especially cogent piece specifically addressing Nurse Practitioners.  Read it.  I think that there are at least three major takeaways here.
  1. The differences in training between physicians and NP’s is huge, consequential and should not be ignored.
  2. Nurse Practitioners, like every other professional group, should recognize their limitations and know when to call in the heavy artillery.
  3. Even if they have a Doctorate in Nursing Practice, an NP calling herself “Doctor” can be confusing and misleading to patients.
Bottom Line. The message here is a clear one. In order for healthcare to work efficiently in the future, it will be necessary to make increasing use of non-physician practitioners. BUT. Such increased utilization needs to be approached with great care. Guiding principles, such as those set forth in this piece, can help.

Academic Medicine And Direct Primary Care

Direct Primary Care Be advised. This post has absolutely NOTHING to do with a Summit to be held in Kansas City this July, the logo of which appears above. Well, sort of. In fact, this blog indicates why such summits are necessary. You see, academic medicine has no idea what to do with Direct Primary Care. As you will read in the referred blog, academicians think DPC is either a passing fad or a trend that is likely to muck up the evolution of the American Healthcare System. So PCP’s who want to start a DPC practice are largely left to figure out how to do so on their own. So they read articles on how to do it, attend workshops, etc. Is this an efficient way to get things done? Probably not! Bottom Line. Which got me to thinking. As medical students run from anatomy class to pharmacology class in 2016, what model of medical care is being taught to them? What kinds of practice models are they being prepared for? Important stuff to sort out? You bet!

Does Your Doctor “Get It?”

Screen Shot 2016-06-06 at 1.39.00 PM As is not surprisingly demonstrated through this blog post, the Oncologist under discussion “Get’s it.” For this specialty, the blogger offers, “getting it” is having an understanding that the enemy is not death, but rather unnecessary suffering. Good Oncologists, hospice workers, etc. “Get it.” Bottom Line. BUT. What it means to “Get it” varies by specialty. What is true for an Oncologist wouldn’t work so well for a Pediatrician or a Psychiatrist. Spend a moment. Think about the specialty(ies) you work with the most. What does it mean for these doctors to “Get it?” Now think about your own doctor. What do you hope that she “Gets?”

Good Grief!!!

Naturopath   Nice photograph above, right. All kinds of natural stuff. Organic. Good for you. BUT. These are NOT substances that should be trotted out as medications in an emergency. You probably knew that, right? But check out this discussion of a question on the examination one takes to become a Naturopath. Yikes! A kid whose life might well be in danger is going to be “treated” by somebody who has never even seen such a kid in training? Give me a break! Bottom Line. Just for giggles, I Googled Naturopath to see whether we have any on Hilton Head Island. In response, I got a list of Acupuncturists, Chiropractors and Lord knows what else. All apparently licensed in, and by, the State of South Carolina. I remain in awe that in our theoretically civilized country in 2016, regulators still allow this kind of nonsense to be perpetrated on our citizens. WHY???