Gasping for breath, Michael (name changed) pushed back in his chair. His legs felt like lead weights. He could not delay the rescue call any longer. The oxygen in his blood had dipped into the 80s.
An X-ray showed a shadow over the lower part of Michael’s right lung, and the hospital admitted him to treat a pneumonia. A smoker for decades, he was relieved a few days later to be …
How profit-driven hospitals fail long-term patient care
If it ain’t Boeing, I ain’t going—at one time, public opinion of an engineering company run by engineers. Today, perception is a little different. The multinational conglomerate and defense contractor owns some staggering recent mishaps—safety systems, door plugs, unclear technical issues. A disconnect between senior management and hands-on employees is reported. Analysts consider recent events symptoms of longer-standing organizational pathology, finally coming to light.
In American business, executives win leadership positions …
Navigating organizational dysfunction: lessons from Boeing
The eyes can’t see what the mind doesn’t yet know – an axiom to remind us not just of the value of lifelong learning, but that the answers are often in the exam room with us.
Though bright and committed clinical people we may be, we’re dragged by the tendrils of a lumbering behemoth. American health care is designed to produce revenue and built to punish highly visible mistakes over more …
Lifelong learning: a game-changer in diagnosing dizziness
Our memories are tricky. Whether we inflate experiences in recollection or allow their wonder to slip back among the ordinary depends on our perspectives at the time between present and past. The trouble is that we are no good at knowing in which direction we’ve erred.
We counteract this flaw with record-keeping, and these words are an entry into our shared ledger. They are attestations of what is owed to the …
The following article is satire.
According to several very old studies, interventional patient-centered bipedal locomotion (sometimes informally referred to as walking) might be an important part of good hospital care. Programs focusing on this treatment are reportedly under consideration by administrators at some facilities.
“As we look to streamline interoperability and optimize outcomes metrics, we’re thinking about anything that we could attach a number to,” says Larry Perry, Chief Medical Information Strategy …
Hospital administrators thinking about no-cost treatment which really helps patients
Is your patient having trouble breathing? I can ask respiratory to give him a nebulizer. I’m looking at his chest X-ray now — why don’t we bump up that Lasix, too? I wish the ER would have grabbed an ultrasound of that swollen leg. Does he need more oxygen?
If something is missing from this picture, it isn’t the clinical people who are at fault.
Clinicians solve problems with the tools they’re …
Hospital immobility is an encapsulation of our system’s fundamental flaws
Words are powerful. So few symbols can evoke such deep feelings and rouse incredible emotion: “I have a dream.” Language is the achievement that makes us who we are. But while you, I and everyone else employ the same words to communicate shared ideas, what those words mean precisely to each of us — among the many views and opinions that make us unique individuals — can be very different.
I …
The problem with these specific words in health care
Burnout is a myth. Dedicated clinicians, working under circumstances that connect their skills and compassion with opportunities to impact patients, won’t experience burnout any more often than they might by doing other jobs. The story we tell — the one that dissatisfaction is this system’s inevitable byproduct — perpetuates more harm than we know.
This is what I’d like to believe. I’d like to write about the many opportunities to do …
Refuse to accept that burnout is a natural experience in health care
More than two-thirds of Americans use social media, and 90 percent of adults in the U.S. have a cell phone. With these tools surrounding us, we must be more connected with one another than ever before. Right?
It doesn’t feel like we are. At least, the people who engage with the health care system don’t feel connected to the rest of us. They feel lonely. It feels like we send them …
Social isolation is a health risk
In health care, we enjoy a unique opportunity to create special relationships with our work. Few enter these professions for practical reasons, and fewer still survive rigorous training without genuine belief in what they might accomplish. And cliched though they may be, the many mission statements which purport the “art of caring” do convey something real.
But to even for the naïve, spending enough time around health care produces a certain …
Take ownership of our broken health care system now
Less than one year ago, on an early fall evening in Las Vegas, 59 people were killed at the outdoor Harvest music festival. A single shooter injured hundreds more, using firearms purchased through lawful channels.
There have been many mass shootings in our country, before and since, and in 2015, deaths from gun violence eclipsed for the first time deaths from motor vehicle accidents.
Not long after Las Vegas, discussion emerged in …
Limiting access to guns may not be the best solution to the present crisis
Medical care and understanding have changed since separation of physical and mental health made much sense. We know now that mental state and internal physiology influence one another and that social factors affect disease risk more powerfully than genetic ones. Still, as a health care system, we perpetuate a culture of division, and limit our capacity to help people because of our inability to categorize them neatly.
There are so many with unmet mental health …
How can we improve mental health screening?
It’s a health care buzzword for sure, but when we talk about quality, what do we mean? We can compare the quality of similar things and focus on its absence, but otherwise, putting the idea into words becomes complicated. Context is important. And so is perspective: One’s position within the health care system influences how he defines quality to a larger degree than it does at a restaurant, or in …
When we talk about quality, what exactly do we mean?
I took a great continuing education course recently, and had an opportunity to review some useful skills and fascinating cases. Because health care knowledge areas expand more quickly than most and keeping current is an integral part of doing these jobs well, it was easily worth the time.
The cost seemed unreasonable, but I was only superficially interested in that anyway; like most, I’m fortunate that my employer offers a generous …
The moral hazard of health insurance
In hospitals today, administrators are eager to impose guidelines and metrics onto any facet of patient care they can measure. The sentiment that business people and clinical people are at odds flares with each new initiative. Clinicians feel ignored. Patients complain about how little attention they receive. Administrators try to distill complex pieces of information into smooth line items. We all spend as much time with computers as we do …
Health care is teaching to the test
Helping our patients make better health decisions can be a challenge. Whether we aim to get them out of bed in the hospital or off of the couch at home, factors contributing to follow-through may be complicated, and the best strategies to facilitate the right choices are seldom clear.
As providers, we would hope that a long and healthy life would serve as the most powerful incentive for behavior change, but …
We are all responsible for behavior change
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