June 13th, 2010 by Edwin Leap, M.D. in Better Health Network, Opinion, True Stories
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I was about to leave work a few nights ago when EMS was dispatched to a 10-50, which is a motor vehicle accident.
Enough years in emergency care and that tone makes your radar, but doesn’t create much of a blip. Many of those crashes have EMS arrive, only to discover no injuries. Some have patients transported, with minor problems that lead to their speedy evaluation and discharge from our ER. A few have serious, life-threatening injuries. They take all our speed, skill and attention to save life and limb. And often, require transfer to other facilities.
But this last call was none of those. Around 1AM the radio traffic crackled back to dispatch (which we could hear in the emergency department): “Probable Signal Nine.” Signal Nine means the victim is dead at the scene. Not “Dead On Arrival” (DOA) at the hospital, but no hospital necessary.
I knew the paramedics were finished when they asked dispatch to call for the coroner. And my heart sank a little. For all that a multi-trauma is work, I’d rather do it anytime than have someone die, and someone learn of the death. Read more »
*This blog post was originally published at edwinleap.com*
April 7th, 2010 by DrRob in Better Health Network, Opinion, Primary Care Wednesdays, True Stories
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If there is a central theme to this blog, it is this: Medicine is a human thing.
On the Facebook page of my podcast, I recently asked for readers to tell me some of the “war stories” they have from the doctor’s office. What are some of the bad things doctors do wrong? I quickly followed this with the flip side, asking readers to comment on the best interactions that they’ve had with their doctors.
The response was overwhelming, and equally quick to both rant and rave. They told stories about doctors who didn’t listen, explain, or even talk with them. They told about arrogance and disconnectedness from the people from whom they were seeking help. They also told about doctors who took extra effort to listen and to reach out in communication. They talked about doctors who genuinely seemed to value them as humans. Read more »
*This blog post was originally published at Musings of a Distractible Mind*
April 29th, 2009 by Stacy Stryer, M.D. in Uncategorized
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Yesterday I was sure that I wasn’t going to talk “swine.” Twelve hours ago I had almost, definitely decided on my topic. And it wasn’t swine flu. But sometime between then an hour ago, I changed my mind. I’m allowed to do that. It’s my blog. And, guess what. I changed it again.
I actually began to write about the swine flu but then took a break – for a very important reason. My sister, daughter and I had to start decorating hats for friends and family members who will join us this weekend to participate in the brain tumor walk in Washington D.C. Each year we form a team in memory of my husband, who died 4 years ago. As I was about to start writing my “swine” blog again, a friend and fellow team member emailed me to make sure that I pick up a “yellow” shirt for her tomorrow instead of a white one (when I pick up team members’ shirts for them), indicating that she is a brain tumor survivor.
This weekend always marks the beginning of two weeks of intense emotions. It begins with the brain tumor walk, moves onto the anniversary of my husband’s death in the Jewish calendar, then his birthday and, the day after that, the anniversary of his death in the common calendar.
This weekend also serves as a reminder of how important friends and family are. Each year I am amazed by the number of people who join me to celebrate my late-husband’s life and to support our family. While my children have to carry the burden of their father’s death, they also have learned how important life is and how lucky they are that so many people care about them.
It is difficult to know what to say when somebody becomes terminally ill or when a family member dies. What are the proper words? For the most part, it is not the exact words that matter. What does matter is that friends and family are there to show support. Immediately – and a week later. And 6 months later. And 2 and even 4 years later.
Some of my friends began to check on my weekly after my husband died and, to this day, still check on me the same day of every week. Others called me recently after a religious leader in my synagogue was diagnosed with the same type of tumor my husband had – because they wanted to make sure I was doing OK. Likewise, my daughters’ friends, who are now 5th graders, watch out for her. When a classmate’s father recently died, it upset my daughter greatly. That evening I received several phone calls from her friends’ parents, who had heard she was very sad. I also received a phone call from her guidance counselor, letting me know about the death and making sure my daughter was OK.
We have over 65 people walking with us this Sunday. Our team is comprised of aunts, uncles, in-laws, and cousins. It also include teachers, a principal, and an old patient of mine. Plus, there are friends of my husband’s, good friends of mine who barely or never knew him and, of course, old and new friends of both of my daughters. Some didn’t even know my daughters when their dad was alive.
I will keep my fingers crossed that most of the people walking this Sunday are accompanied by someone wearing a yellow shirt, rather than just a sea of white.
February 25th, 2009 by Dr. Val Jones in Primary Care Wednesdays
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By Steve Simmons, M.D.
Last week my partner wrote about The Funnel, and illustrated how patients are squeezed through a healthcare system that focuses on specific problems without allowing enough time to treat patients as individuals. We have shown how frustrating this is for doctors and demonstrated that a shortage of primary care physicians is a reality. However, we don’t believe it’s too late to reverse this foreboding trend. Today, my partner and I at doctokr Family Medicine are building a practice to care for our patients as individuals first. We have also added our voice to a growing chorus of physicians sounding ever louder, explaining the necessity of a healthcare system that places the art of caring for patients first.
The next time you sit in a doctor’s waiting room, look around and consider what, and more importantly who, you see. You might see a sick child or his worried mother. Our healthcare system does not see two people, rather it sees a 5-digit CPT and ICD-9 code. ICD-9 (International Classification of Diseases) codes were originally created by the World Health Organization (WHO) to track diseases across the globe. Today, CPT codes (designating patient difficulty) are combined with the ICD-9 codes by third-party providers to standardize the reimbursement process. Although over 17,000 ICD-9 codes exist to classify various illnesses, there is no code for compassion. More concerning, the system does not allow any time to ease the worries or fears of a mother.
The focus of a primary care doctor’s medical practice should be on the art of patient care. An individual should be treated as a whole and not the combination of their individual problems. But, a time may come when we must focus on one specific medical problem and seek the help of a specialist; such as an endocrinologist for diabetes or an orthopedist after an accident. Yet, without a primary care physician to coordinate our care and speak on our behalf, a patient’s wants and needs as an individual might not be considered in reaching a particular treatment decision. I can speak as a doctor, son, or patient when I say that anyone’s health can suffer at the hands of brilliant physicians working without the guidance of a coordinating physician who knows us well.
My mentor in medical school was an experienced family physician near retirement who offered me the following insight. There are two types of doctors and I would consciously or sub-consciously choose which one to be. One type of physician makes medical problems central in their patients’ lives and thus forces the individual to revolve around their problems. The other type works to keep the patient’s life central and tries to make problems rotate around the individual.
Those policy makers determining the future of healthcare should follow my mentor’s advice. Today’s health-care system has devolved to focus solely on problems and disease, often to the detriment of individuals and families. As decision-makers explore revamping our current healthcare system they could continue, unaware, in this same direction. But, I have to believe they would choose the other direction if they could remember how it feels to sit in a doctors waiting room surrounded by other people – individuals all. Nothing will change the fact that healthcare is ultimately about people, and not codes or a specific problem. Healthcare should help patients and their primary care doctors make good health and wellness decisions while basing them on an individual as a person.
Until next week, I remain yours in primary care,
Steve Simmons, MD
