It’s interesting to read about medical providers who are not only coming up with innovative treatment plans, but also finding that good medicine is good for the medical providers bottom line. I came across an article in the business magazine “Fast Company”. They showcase cutting edge ideas and this one about healthcare caught my attention especially in the midst of a political campaign where the candidates are talking about healthcare reform.
The treatment in the article is a coronary artery bypass graft. They state that they are charging a flat fee and if the patient incurs any preventable complication putting the patient back in the hospital, the hospital picks up the tab. They have come up with a forty step process that standardizes the treatment protocol so no one involved in the patient’s care overlooks any one item. Accountability is included in this process helping to cut down or eliminate missed steps increasing the success rates.
Does the 40 step plan work? Glenn Steele Geisinger Health System’s CEO had the procedure done and it was successful. Following the surgery he received an e-mail stating that 113 people had accessed his medical records during his stay, all authorized. This is why they believe the 40 step plan works because everyone is kept in the loop. Can you imagine coordinating 113 people for one patient? This increases communication and keeps everyone on the same page.
They say this is their first process to be implemented but more will come. I believe that any time you can increase communication surrounding the care of the patient it’s a true benefit. When everyone is speaking the same language, following the protocols it means that there is less confusion, and that means less chances for the patient to be harmed.
It’s important that we continue looking for ways to increase access to healthcare. If we can do this while still maintaining the highest levels of care so that fewer complications result in fewer deaths we’re ahead of the game. When all eyes are on the patient that’s good. Don’t get me wrong, I understand that all eyes are on the patient and the pocketbook, but for now we’re heading into uncharted territory. Let’s sit back and see where the next leg of the journey takes us.
I was shocked yesterday when I read a report about the increase in deaths due to medication mistakes. The shocking thing is that these mistakes happened to people like you and me in their homes. Yesterday the statistics were presented in the Archives in Internal Medicine, Vol 168, #14.
The journal states “Deaths from medication mistakes at home increased from 1132 in 1983 to 12, 426 in 2004. Adjusted for population growth that amounts to an increase of more than 700 percent during that time”. I read these statistics and was horrified. We would all like to thing that we know enough about our medications that we wouldn’t make a fatal mistake. What about those who are on multiple medications due to illness?
The scary part is that most of the mistakes in medications at home are a result of our ever increasing use of over-the-counter medications. There are interactions that without a pharmacy degree we can’t predict. The other cause cited in the journal is the medical communities increased writing of pain medication prescriptions. We don’t realize that certain medications like pain medication reduce our respiration. Depending on what other medications we’re ingesting we could be cooking up a recipe for disaster.
Of course it’s not practical to have a pharmacist living in your home. If you are facing any health challenge be vigilant about what medications you take. Before taking anything, consult your pharmacist. It’s better to ask too many questions of your pharmacist, than run the risk of mixing medications and dying prematurely. Do you really want to run the risk of a fatal mistake?
We get a diagnosis and we think we understand all that entails. Often patients aren’t aware of the complications that accompany a particular illness. You focus on the primary diagnosis and are surprised when something, you think, pops up out of the blue, but to the medical professionals it’s not a surprise.
As an example, let’s look at diabetes. There are the obvious problems associated with diabetes and a medication regimen or treatment protocol involving diet and exercise are implemented. Unless the patient is given a thorough education about the illness they may be surprised when the disease progresses and vision problems occur or down the road kidney failure enters the picture.
It’s not just physical ailments, but psychological ailments as well. Those with eating disorders, if not treated, not only do they continue to lose or gain weight, but a host of problems often arise. In the case of someone who is anorexic, if their weight drops too suddenly and not under medical care there is a chance of kidney failure or heart attack due to electrolyte imbalance. Bulimics run the risk that their esophagus will be eroded due to the acid that accompanies regurgitation.
It’s not only the primary diagnosis we need to be concerned about the secondary and tertiary problems that can arise. This is why patient education programs need to be thorough. If patients are aware of the drastic consequences of their actions, they may be more inclined to be compliant with medication or other treatment regimens.
Have you experienced a secondary illness arising from your primary diagnosis? How did you cope with the complexities of multiple health challenges? What information would you have needed at the start of your journey to wellness to side step those complications? When you share and tell your story you empower yourself and others to be better health consumers.
Many of us make decisions based on facts. Facts are good, they are grounded in some form of reality and yet there is a force greater than the physical reality that can help us make better decisions…our intuition. How often do you pay attention to your gut feeling? Do you use your intuition when it comes to medical care or is that something that only factual knowledge is your guide?
I’ve learned some valuable lessons about intuition and medical care over the past couple of months. I have four animals and three of the four are seeing specialists. Yes that’s right I have two that are seeing the Dermatologist/Allergist and one who recently had double ACL surgery. During each doctor’s visit I was very in tune with my intuition and these are my findings.
My cat, Zedd, went to see the dermatologist. Upon our first visit he didn’t ever touch the animal. He stood a good four feet away and made assumptions about what’s causing the problem. I didn’t know that vets were trained in mental telepathy, I must have missed that on the syllabus. Following the appointment I went back to my cat’s regular vet and told her my experience and how unhappy I was…it just didn’t feel right. Needless to say I changed providers and had my voice heard about the lackluster performance of the doctor. How can you treat without making a connection.
My dog, Bella, had pain and after a couple of consults with the internist and the neurologist the diagnosis was that it was her knees. My consult with the surgeon was amazing. He took me step by step through the surgery. He had models of what he was going to do and the metal plates he would implant in her knees. He showed me the digital x-rays so I could see the damage and super-imposed a diagram about how the knee is supposed to look. I left the exam feeling confident that Bella would be well cared for and that the doctor was as concerned about her as me. On the day of the surgery he called exactly when he said he’d call, his follow-up was amazing.
Now take this information and think about your last consult. Did you feel confident in the doctor? Did you feel like an individual or were you just one more person with the same diagnosis as 100 other patients in the practice? What is your gut telling you about the relationship your establishing with the doctor? These are all important questions because how you feel about the connection will impact your treatment and the outcome of your treatment. If you walk around always feeling uneasy or leery of the decisions how will you put all your own energy toward getting well?
Do you have any stories about how your intuition impacted your medical care? Let’s share and create community … and thanks for hanging with me on the stories about my pets.
When we go to the doctor with a problem our assumption is that they will be able to figure out what’s wrong and fix it. Personally, I think that’s a lot of pressure to put on the medical community. Remember they call it the “practice” of medicine, not the “perfection” of medicine. I say this because over the past couple of weeks I’m hearing from more people that the doctor’s they’re seeing aren’t sure what’s wrong.
In addition, maybe it’s the body that’s fooling the medical community. Yesterday I got a call from someone who had a biopsy that was inconclusive. We might want to ask how’s that possible, but it means that the body isn’t giving up its mystery. The hope is that further tests, or whatever the next steps are for diagnosis will be pursued because treatment can’t begin without a diagnosis and it helps if the diagnosis is accurate.
Many of us facing a life-altering health issue are living in a black and white world. Because it’s our health at stake we can’t stay in the gray and that’s frustrating. I’ve talked to many people over the years who felt the diagnostic process was more unbearable than the ultimate diagnosis. It’s the inherent knowledge that something is wrong but not knowing exactly what, keeping us on pins and needles that makes you pull your hair out (fortunately I don’t have any hair).
I guess what I’m saying is that when dealing with uncertainty stay in the realm of asking questions. When you stay in the space of the question you’ll help smoke out the real issues helping end the guessing game and landing firmly on your feet.
Let’s face it, life happens. We don’t have blueprints for how our lives are laid out. There are no guarantees about anything much less our health. When you work with individuals who face life-altering health diagnoses you begin to play detective based on information about a person. When I heard that Senator Ted Kennedy had a seizure my first thought was a tumor. I didn’t know where in the brain it would be located, but given his age and relative good health for a 76 year old man, it just made sense.
This really tells us that no one is immune to a health crisis. Think of Humpty Dumpty…all the king’s horses and all the king’s men couldn’t put Humpty back together again. Unfortunately the same is true for Senator Kennedy. No matter how many connections he has, no matter how much money he has and no matter how famous and a champion in politics he may be, he won’t be put back together again.
It’s a wonderful fantasy that money and success bring good health. Obviously that’s not the case. Look at all the women in the entertainment world fighting breast cancer. This week we saw the passing of Sydney Pollack, a 73 year old man who couldn’t be put back together again.
No one is immune to the body’s betrayal. We can take steps to reduce our risk, but in the end it only takes one cell or one gene to have a mind of its own and we’re at its mercy. Give yourself the benefit of increasing the chances for health, but don’t feel that you’ve been picked out of a line-up based on specific characteristics. I don’t believe in a million years that Senator Kennedy would have considered facing the challenge of a brain tumor. We’re all in this together.
Last night I gave a talk to an artist group about living a creative life. Some of the audience members want to earn their living by making art. I personally make art because it makes me feel better. Over the years I’ve found that it grounds me, keeps me present and is a visual twist on the “Dear Diary” version of my life.
Currently, I’m enrolled in a PhD program where I’ll be focusing on Art and Healing. When I disclosed that to the audience they were surprised. Then I also disclosed my own health challenges and how art has created a safe haven for living with illness. After the talk one of the artists came and offered to be a case study if I needed one for school. She has been living with an illness for over thirty-five years and finds that art helps build her immune system, lesson symptoms and give voice to her challenges and her life.
It’s important to open up avenues of communication so that people don’t feel so alone. When they are given a container to express themselves and is safe, there is a sense of relief and joy at not having to keep the secret inside. We can develop communities of care if we disclose our reality. It’s powerful and it’s healing.