Archive for the ‘Medical’ Category

Service of Medicine

Thursday, July 30th, 2009

We felt Jeremiah’s response to a comment Matt Mecs made on July 23 deserved more air. Matt brought up healthcare in light of the timliness of the issue in his reaction to the post, “Service Beyond the Call.”

Jeremiah wrote:

I saw my dentist today who for two decades has kept me happily chewing. I, and not some insurance company, pay him. In other words, he works for somebody he knows, and I think, trusts.

He told me that the very complicated and sometimes risky things he does (he is a surgeon) don’t make him anxious, it is what goes on when he does not have a patient in his chair that causes him to worry. Since he was a young dentist, he has had sufficient confidence in his skill and knowledge to operate pretty much on “automatic pilot,” to use his words.

I asked him if he had ever made a mistake. He replied, “No. I’ve done the right things, followed the called-for procedures even in the most complex situations, but the consequences haven’t always worked out well for my patients. That’s inevitable. We can’t possibly always predict the unpredictable, and humans are the most unpredictable of creatures.”

I think most, but by no means all, doctors are like my dentist. They do care and like what they do. It’s the other “stuff”–insurance nonsense and obnoxious patients, for example–that causes them angst. If we reduce the other stuff, we’ll get better medicine.

Let’s weed out the doctors who don’t care and are in it for the buck. We’d all be better off if they did something else for a living.

Let’s let each patient, no matter how rich or poor, know what the treatment they are getting really costs and why. Then let’s have each patient pay at least something towards the expense of the treatment. In other words we should put the human back in the relationship between patient and doctor. Both are too detached from reality now. Maybe people will think twice before agreeing to having the most expensive pill or undergoing the most expensive procedure, when far less expensive options might also succeed.

Lastly, let’s get the lawyers out of medicine. I think it is precisely an adversarial attitude that good lawyers (and good football teams) thrive upon. This is a big part of the problem, and it brings so much grief to a business meant to make people well. In health, there should be no losers. To win, some drug companies “cheat” on testing to get their new product to market first. Insurance companies try to get out of paying for necessary medical care. Doctors perform expensive procedures to make up for the costly time-consuming, [if done properly], patient examinations for which they are inadequately paid under insurance plans. Nurses get sloppy because somebody yelled at them unnecessarily, and so forth, almost to infinity.

I’m grateful to my dentist, and he’s grateful to me, if only because I pay him. I’m not his enemy, and he is not mine. That’s the way it should be.

Do you think that a healthcare system as Jeremiah describes it is viable?

 

Packaging that Serves to Annoy

Monday, April 27th, 2009

A colleague plunked a round pillbox on my desk last week and asked me if I was able to open it. It was white plastic and the opening instructions, “press the dot,” were also white, indented in a kind of intaglio.

The medication was for migraine headache.

I was feeling fine until I couldn’t locate the dot! Eventually I did, but by then I almost had a migraine myself. You don’t have to have suffered more than a mild headache to know what a nightmare it is to fool around with a bottle top to get at an Advil, Bayer or Bufferin. Imagine being blurry-eyed with pain looking for a white-on-white dot. There must be a better way.

It’s not always the fault of the package. Tricky medicine bottles are obviously designed to save children from swallowing dangerous medications but there are times when the easy-to-open variety is in order. When my sister slipped on ice and broke her wrist, the hospital staff asked her a slew of questions. One was, “do you live alone?” Her answer: “Yes.” When she got home and tried to open the painkillers they gave her with only one hand in operation, she discovered that the bottle had a childproof cap.

If you’re slightly uncoordinated, try pressing and twisting open certain mouthwash bottles.

 

A box of brown sugar is easy to open but the sugar turns into a brown brick once you open the plastic inside, no matter how carefully you re-close it with tape or rubber bands.

So that toothpaste can no longer be accused of breaking up marriages, i.e. “You never put the top back on the toothpaste tube!”–some manufacturers attach the top to the tube. In my experience, those tops usually don’t stay closed, making me want to divorce the manufacturer.

Do you have favorite packaging grumps?

Vital Service

Wednesday, April 22nd, 2009

On the back of my New York State driver’s license is an option that reads:

“I hereby make an anatomical gift to be effective upon my death of

-Any needed organs or parts

-The following body parts”

A friend, Sharon Clancy Lienau, recently of Chicago and now a South Carolina resident, would urge you to check “yes” to one of these. So would her husband, Hank.

Sharon has made a major adjustment to her life’s work. Hers was a household name in the marketing of high end decorating products, interior designers and architects. Now, she promotes organ donor awareness. She’s proof of its importance–she received a liver transplant in Piedmont Hospital in Atlanta in 2008.

Sharon has already begun to fulfill her mission. Her letter to the editor in People magazine [April 20 issue] praised Natasha Richardson’s family for donating her organs after her untimely death and Sharon’s story appeared in the Savannah Morning News on April 21 http://savannahnow.com/node/709907 in “Transplant recipient grateful for ‘an unusual blessing.'”

In the article, Dana Clark Felty quotes Sharon: “It’s quite an unusual blessing. It’s a feeling that you’re saying ‘I’m here for a reason and I have to follow whatever that is and what I’m going to do is promote donor awareness for the rest of however much longer I have to live.'”

This is what true service is about.

Have you checked off your organ donor option on your license and told your family of your wishes? Do you know of others who have benefited from such a priceless gift?

Savannah Morning News photo of Sharon and Hank Lienau

Savannah Morning News photo of Sharon and Hank Lienau

The Service of a Financial Crunch—Part 2

Tuesday, March 17th, 2009

Greed may be rampant these days as evidenced by Ponzi and other schemes big and small crawling out of Wall Street’s woodwork and by unjustifiable bonuses provided by the public’s money, but so are generosity and a spirit of looking out for others.

Take the staff  at Beth Israel Deaconess Medical Center that Boston Globe columnist Kevin Cullen wrote about on March 12th. It’s a Harvard Medical School teaching hospital and employs 8,000.

Cullen described what president and CEO Paul Levy said to his staff after touring the hospital for days, observing procedures big and small. He saw how caring and essential-to-healing the transporters, food-delivery, cleaning and maintenance men and women were to patient recovery.

I can vouch for that. A family member was in Lenox Hill Hospital in New York last summer where the woman who changed the sheets made us laugh and a guard, noting that we were freezing waiting for a test in a drafty, over-air conditioned hallway brought us blankets just warmed in a microwave oven. We hadn’t asked him—he volunteered.

Back to the president/CEO, whom Cullen quoted speaking with the staff at the Medical Center:

“I want to run an idea by you that I think is important, and I’d like to get your reaction to it,” Levy began. “I’d like to do what we can to protect the lower-wage earners – the transporters, the housekeepers, the food service people. A lot of these people work really hard, and I don’t want to put an additional burden on them.

“Now, if we protect these workers, it means the rest of us will have to make a bigger sacrifice,” he continued. “It means that others will have to give up more of their salary or benefits.”

“He had barely gotten the words out of his mouth when Sherman Auditorium erupted in applause. Thunderous, heartfelt, sustained applause.”

Cullen ends the column:

“Paul Levy is trying something revolutionary, radical, maybe even impossible: He is trying to convince the people who work for him that the E in CEO can sometimes stand for empathy.”

You can read the rest: http://www.boston.com/news/local/massachusetts/articles/2009/03/12/a_head_with_a_heart/

Not every business has met with this attitude. A friend in Minnesota notes that the Teamsters involved in negotiations with the Star Tribune aren’t budging and she fears this intransigence may spell the end of a beloved newspaper.

Would you give up salary and/or benefits or fee under these circumstances? Should anyone be asked—or volunteer–to do this? What are the upsides and downsides?

 

 

 

Service When You Want it Most

Saturday, January 17th, 2009

 

Thomas M submitted a guest post that is such a stunning example of exemplary service that we interrupt the four part discussion of service personalities by our first virtual focus group to share it with you. 

Kindness like this doesn’t come with training.  To the recipient, it’s a gift.  And don’t you have confidence in such a person?

A year ago I was diagnosed with lung cancer, a diagnosis that was followed by surgery, chemotherapy and radiation. For now, all clear. One year later, almost to the day, a mammogram and ultrasound revealed a breast spot that, following a biopsy, was deemed cancerous.

It is so small, my doctors are surprised it was even discovered. The detection, by itself, falls in the category of superb service. That attention to detail by the doctor who read the mammogram, performed the ultrasound and called back for another look just to be sure no other spots lurked, and by the doctor who performed the biopsy painlessly and with precision, thoroughly parallels the many services I have received from a growing team of doctors, nurses and caregivers at Pennsylvania Hospital and the other involved branches of the University of Pennsylvania health system.

Their professionalism and skill, has been, of course, critical to my wellbeing. But at least equally important -maybe more so -are the kindnesses that accompanied me every step of the way -not just from surgeons, physicians, the oncologist and radiologist, but also from every nurse, assistant, receptionist and social worker (to unravel insurance hitches) that I encountered over the past year and still see during follow-ups.

Let me also praise their cooperation with each other and the speed of their communication among themselves and with me. Following the breast cancer discovery, I called three of the doctors to run the name of the recommended breast surgeon past them. All returned my call immediately and confirmed the one they considered best. I’ve Googled her. She is. A phone conversation with her incredibly efficient office manager adds to the confidence I will take with me for our first meeting next week.

It’s impossible to give every example of the superlative service I’ve received, but today’s experience illustrates the point. It is Saturday, and my oncologist just called to tell me he has spoken with the breast surgeon to discuss my history and go over this most recent diagnosis. The call had another purpose: To quell my fears. “Don’t worry,” he said. “It’s so small I’m surprised they found it. It’s an isolated event, not related to lung cancer and not something you need to worry about.”

It’s Saturday. This is no emergency, and a call from him was neither expected nor needed. It was a kindness. I’ve read the many comments on this blog that discuss the relationship between service and kindness. With much gratitude, I submit a year’s worth of evidence of this truth.

Healthy New Year

Tuesday, December 30th, 2008

Sam had gone home. He’s the New York City coffee vendor on 44th Street and Third Avenue [see “Coffee Service with a Smile,” December 15th], and I was paying for a cup of coffee at a deli near the office. A customer ran over to the cashier from the sandwich counter on the opposite side of the deli asking, in a booming voice, “Who’s coughing here? I can help you!”

He queried the cashier, who doesn’t speak much English. She simply smiled at him, [and as soon as he left, started coughing again], so to anyone within hearing distance, he said, “Come to my store,” and he pointed to the embroidered Invite Health logo on his white medical jacket, “and I’ll give you something for that cough.” Invite Health sells nutritional supplements. What a salesman! His enthusiasm promised the best attention if you dropped in.

Speaking of white medical jackets and service, we recently returned from a visit to a Connecticut-based specialist in, among other things, tick-borne diseases. I’ve heard people say that when some politicians speak with you in a crowded room, they make you feel as though you’re the only person in the place. While he’s with you, this doctor, John Magaldi, makes you feel that you are the only person in the world.

He accepted no phone calls, [I didn’t see a phone in the examining room], and nobody knocked on the door with urgent messages and until we’d asked him all our questions and my husband stood up to leave, he didn’t budge from his seat or look at his watch. My husband had a 145+ page file from a summer hospital stay in New York City–erichliosis was the culprit [you get it from a tick]. It had played hide and seek with a gazillion blood and other tests for months. Dr. M.’s questions made clear he had read the file. You feel better after seeing him, that’s for sure.

To welcome the New Year and in stride with the theme of this post, we turn for inspiration to the nurse/receptionist at a city doctor who cares for us. “Stay away from doctors!” she exclaims every time you head out the door of his office.  We hope you can. And here’s to 365 days filled with happy surprises.

 

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