Category: Quality of Life

Aging in Place

Check this out. What you will see is a reminder. A reminder of the depressing state of the “nursing home crucible”, in which many senior citizens unfortunately end their days. Nursing homes, by whatever name, have always been unfortunate places. But the COVID-19 pandemic, with residents locked away from relatives and disproportionately dying of the coronavirus, nonetheless, brought to this physician blogger a clearer image of the wrinkled fingers pressed against windows, longing to be back in the real world with their relatives in their final days.

Bottom Line. The message here? As a society, we need to do a better job of helping our seniors to “age in place.” We have the tools that are necessary to do that. 

We just lack the commitment! 

Cultural Differences

The man you see above is a very surprised Indian uncle. Surprised because his niece just informed him that she is going to study engineering rather than medicine. A simple matter of career choice, right? Not so much!  

Check this out. What you will see is the revelation that becoming a physician in India carries with it great personal risk.  If a patient, even a very sick or elderly patient, passes away, a physician can suffer physical harm from a “mob” seeking retribution. Yes, I am serious. In a country like India so desperately in need of better medical care, here is but one more factor likely to contribute to a severe physician shortage.  

Funny. When Saurabh Jha, the physician uncle pictured above, came to Philadelphia for medical training, he found the U.S. form of retribution. He couldn’t get a car because he couldn’t afford the high auto insurance premiums resulting from litigation for such “serious” auto accident sequelae as “whiplash.” 

Bottom Line. Mob violence vs. Litigation. Auto accidents or medical malpractice. India vs. U.S. Every culture has its own form of payback. Unpleasant though it may be, I will take the U.S. version every time!

How An Orthopedic Surgeon Deals With The “Imposter Syndrome”

I suspect that everybody reading this post is familiar with the “Imposter Syndrome.” It is the feeling, held by many very successful people, that things are “too good.” That they can’t really have achieved what they really have achieved. AND. They are going to be found out, and their success will all disappear!!!

Check this out. The story of a young and successful shoulder surgeon who suffered from Imposter Syndrome her whole life, and especially when she entered medical practice. I’ve thought about this. Picture the very first time this doctor, or any surgeon, is “on her own” in the operating room. No supervising physician present. She is the captain of the ship. As she raises the scalpel for the first time to cut into a patient’s body, is there any way that she or any right-minded surgeon would not ask herself, “Am I really qualified to do this?”  “Nah, I am an imposter.” “They are going to find me out, but by then it will be too late for this patient on the table in front of me.”

As an amusing aside, one of the worst attacks of IS this doctor had was when she went big time into social media. Other orthopedists weren’t doing this. What made her qualified to do so?   

Though the diagnosis of Imposter Syndrome was only brought forth in 1978, I am betting that physicians, and particularly surgeons, had had that feeling decades, if not centuries, before its publication.

Bottom Line. The good news is that this blogging physician figured out how to cope with IS, and even has a website to mentor physicians on how to cope. Know your strengths, listen to the supportive things that people say about you, AND embrace your failures. Realizing that you overcame them will make you stronger.  

I am guessing that it is not just physicians that can benefit from these insights!

Drinking Problem???

I’m no expert. However, I feel confident in my guess that the woman pictured above probably does have a drinking problem! BUT. As this article notes, drinking problems cover a wide spectrum of severity. But that is not the point of the article. Nope. Rather the article announces the availability of an “online tool” which enables people who suspect that they might have a drinking problem to respond to a brief survey and know for sure. Moreover, the tool also recommends the type of treatment that might be appropriate in an individual case. I have a couple of problems here. First, look at the sample survey questions presented. Seems that if you answer yes to any of these questions, you could probably figure out for yourself that you do indeed have an alcohol issue. More tellingly, I wonder whether somebody with a drinking problem is really going to utilize an online tool to confront the issue. Finally, I note that only about a third of patients who go through all of this, and finally do wind up getting treatment, are better off a year later. Bottom Line. No doubt about it. As pointed out in the article, alcoholism is a serious/widespread/growing problem. If a cyber tool like this helps even a few people, it is worth a try!

I Am Not Quite Sure Why …

Meditation But I think you should go here and look around. What you will see are the musings of a physician who takes relating to patients to a new level. He spends significant amounts of time meditating “on the mat,” attempting to get better connected to himself so that he can get better connected to patients. Why does he meditate? Because, he argues, “I don’t have the time not to.” I tried to pick one of his posts to focus on exclusively here. I failed.  Like I said, look around. You need to contemplate an array of the posts to “get it.” This doc is not just about diseases and prevention. His mission statement is:

“…to help people improve their health and lead meaningful fulfilling lives.”

Bottom Line. I like it!!! This approach is not for all doctors, and not for all patients. BUT. I think this is really powerful.  And one thing I think I know for sure. This Doctor is NOT going to “burn out.” He is just going to keep getting more and more connected. To himself and to his patients.  Good stuff!

Health Partner

Johnson & Johnson I have seen several permutations of this idea before. What we see here is the announcement that Johnson & Johnson is launching  a new platform to assist patients in preparing for, and recovering from, orthopedic and bariatric surgery. The last time I blogged about such a system, I recall noting that many of the surgeons I have known over the years pride themselves on having developed their own systems for patient motivation and follow up. Sure, they are not very sophisticated, with many being no more than an 8 ½ by 11 piece of paper and a bottle of Hibiclens or more profound than a phone call on the preoperative day. BUT. These approaches seem to be working for the practitioners who use them. Bottom Line. Will the JNJ offering add enough value that surgeons will give up their own systems and take the time to adopt the new platform?  Time will tell!

ECT For Autism???

Screen Shot 2017-11-02 at 12.42.33 PM At first glance, this may appear to be déjà vu all over again, but there are significant differences between the electroconvulsive therapy described in this article and the torture chamber antics employed during the dark ages of psychiatry, when it was right up there with lobotomy as last ditch therapy for the mentally ill. What you see here is the courageous reconsideration of a much- maligned therapeutic technique that, in carefully selected autistic patients, can provide a quality of life previously unimaginable. Bottom Line. What are the learnings here? I think that there are a couple. The first deals with risk-reward. The young man described here was a hazard to himself, and obviously took a major toll on the lives of his family and everyone else around him. In these circumstances, it would seem to me, the use of unconventional therapies makes all the sense in the world. The second learning, I believe, is that just because a therapy has been stigmatized doesn’t mean that it might not have practical and important uses. It is important not to throw the baby out with the proverbial bathwater, as this case clearly indicates.

9 Employee Benefit Trends to Watch In 2018

9 Employee Benefit Trends to Watch According to this recent article in Employee Benefit News, next year will see nine important new trends in employee benefits.  While some will relate to our healthcare vertical, like a focus on workplace wellness (Haven’t we heard that one before?), others will focus on financial planning, assistance with student loans, etc. In the healthcare arena, I especially like the trend which looks to increasingly integrate health benefits and retirement benefits. VERY responsive to the needs of our times, in which planning to have good healthcare coverage in retirement years, when health problems really loom, makes all the sense in the world. Bottom Line. But wait! Step back a little, and take another look at this list of trends. The unifying theme here is clearly that all of these trends fit together to help employees to lead less stressed, more enjoyable lives.   All good. My only questions are:  At what cost? and Who pays?

Suicide and The Rural ER

Screen Shot 2017-06-26 at 3.28.40 PM Underserved. We frequently talk about rural communities being medically underserved. Usually, this means underserved by PCP’s.  And usually the recommended solutions have to do with allowing PA’s and NP’s to practice unsupervised in such areas. Or designing special programs to attract PCP’s to rural communities. Educational loan forgiveness and such. But read this piece. You will be reminded of a cruel irony. Rural communities, where closed steel mills and coal mines are contributing to soaring unemployment, in turn leading to soaring alcoholism and other mental health problems, have virtually no Psychiatrists and no mental hospitals. Leading to the kinds of train wreck situations described in this piece. And things aren’t getting better on this front. They are getting worse. No, folks, the mines aren’t going to reopen!!! Bottom Line. I like to close my daily blogs with a breezy little recommendation as to how bad healthcare situations can be made better. Quickly and easily. Unfortunately, folks, today I’ve got nuthin’! Ideas?

Walk With Me…

Screen Shot 2017-05-22 at 11.42.11 AM That is what a physician is inviting us to do in this blog post. Read it. Think about it. He wants us to walk with him through a day of his practice. To see things like he does. Nothing very strategically insightful about health care here. Nothing very profound. RATHER. An artistically rendered snippet about what it feels like to be a physician going through the day. Here we see a physician wrestling with himself. Priding himself in keeping a patient “alive.” Recoiling when he realizes that the catheters, tubes and wires that he has placed may keep vital signs charting, but are hardly supporting life in any meaningful sense of the term. You must keep things “fuzzy” this doctor opines, lest you succumb to the dismay that lies, with the devil, in the details. BUT. You don’t want to keep things so fuzzy that you miss the victories, the real victories, that your medical expertise sometimes actually can empower. Bottom Line. We often forget the soft, human side of being a doctor. We shouldn’t!