Category Archives: Health

On Mutual Respect

Posted on by
5

img_4415

NaBloPoMo 2016, Letters to Patients, Day 5

To Patients Who Abuse Medical Staff:

Let me be clear: That is not okay.

Let’s define some terms first:  By staff, I mean clinic receptionists, medical assistants, nurses, phlebotomists, schedulers, hospital nurses, housekeepers, pharmacists, food service workers, billing and medical record staff, social workers, case managers, and anyone else who contributes to your care.

By abuse I mean insulting, yelling, name calling, intimidating, swearing, threatening, and otherwise conveying hostility and aggression toward others.

I have very specific behaviors in mind here.  I’m not talking about the inevitable frustrations that we all face in over-scheduled clinics and understaffed hospitals.  Exasperation, disappointment, and even anger are appropriate emotions we all share.  We understand that you may make surly faces and splutter a little when your expectations are not met.  Most medical staff are trained and expected to handle such interactions with patience, compassion, and calm.  They are frequently also given only narrow parameters within which to convey information, and almost no decision-making authority or autonomy.  Believe me, they feel terrible when they cannot help you, and often there really is nothing they can do in the moment.  But they can always ask for help, so I respectfully request that you give them the time and space to do so.

The medical community has a lot of work ahead to integrate our care teams.  We serve you best when all team members are empowered to exercise their best judgment, within their scope of practice, to move care forward toward your best health.  We are all here doing our best.  Physicians play a crucial role in both local and global medical culture.  But we are only recently stepping up as actively collaborative leaders, rather than authoritarians and paternalists.  You may see us physicians abusing our own staff, so let me be clear again: That is also definitely not okay.  Never mind that it undermines morale.  It can also endanger patients.  I hope in my lifetime to see an end to this contemptible behavior.

If I witness you abusing my staff, be sure that I will call you out.  I will do it respectfully, even lovingly, especially when I know you’re going through a hard time.  I understand how hard it is to control our emotions when we’re unwell and frightened.  It’s good for all of us, however, to know exactly where the boundaries of acceptable behavior and language lie.  Expect that if you cannot abide them, I will ask you to leave.

If you witness me or my colleagues abusing our staff, we need you to call us out, too.  Relationships are never one direction.  In medicine and health, the webs of connection are inextricable—one person’s mood and attitude can rapidly infect a group—and the stakes can be high.  I expect myself and my staff to conduct ourselves professionally.  We expect you to behave humanely.

Thank you for your cooperation!

On Walking the Talk

Posted on by
2

img_4304

NaBloPoMo 2016, Letters to Patients, Day 4

To My Patients Who Wonder, “How Healthy Is Your Diet, Doc?”

I cannot tell a lie, it kinda sucks sometimes!  I’m not a foodie, really.  In fact, I have maybe the least discriminating palate of anyone I know—everything tastes good!  I particularly love sugar, starch, salt, and oil—especially in combination.

So when I talk to you about the picnic plate method of eating—half stems/stalks/leaves/fruit, a quarter high quality lean protein, and a quarter whole grain—believe me, I understand the challenge!  In fact, every time I counsel you, I review my own food log in my head, and I resolve to visit the raw salad bar more often.  When I give advice or make suggestions, it’s not that I necessarily know better than you, or that I think I’m better than you.  We’re all here doing our best every day.  It’s my job to look out for your health, which research tells us is only 20% related to what I do in the clinic or hospital, and 30% related to your own habits (incidentally, it’s 40% related to your environment).  So if I can help you make even the smallest change for the better, then I feel useful.

When I ask you about exercise, sleep, stress management, and relationships, I am also taking stock of my own habits in those realms.  To me, these are the central domains of health.  And nobody has a perfect balance all the time.  Maybe you’re great at exercise, but your diet is the pits.  Maybe you eat really well, but you stay up too late at night.  Everybody’s patterns are different, and they shift over time.  Sometimes I might share my own fluctuating experiences with you, if it feels relevant and helpful.  But our time together is about you, not me.

I want you to feel free to ask me how I manage my own health.  It’s important to me that I Walk the Talk.  I will answer honestly, if sheepishly.  I will share my struggles with you.  I risk judgment by you when I do this, and I accept that.  One of you actually said, “Shame on you,” to me one time.  Maybe you feel judged by me, also?  I think that is inevitable.  We all judge ourselves, and then subconsciously project our judgments onto others.  I’m working on self-compassion—ask me about that, too!

It’s about strategy and execution, trial and error, and repetition.  No matter what the behavior change, the more times we try, the more likely we will finally succeed.  So the next time you come in and we talk about health habits, think of it as comparing notes, rather than reporting progress or regress.  If you found something that works, please share!  I might just steal the idea for myself.

On Plumbing and Other Disciplines

Posted on by
4
https://pixabay.com/p-156741/?no_redirect

Cartoon courtesy of Pixabay

NaBloPoMo 2016, Letters to Patients, Day 3

To My Patients With Diverse Occupations:

What a pleasure and an education to know you!

I think none of you are plumbers, though.  But I remember the first time I met a plumber—it was in college, a friend of a friend.  To this day I wonder if he thought I was a little crazy—I grilled him mercilessly about his work.  Was it like “Moonstruck,” is copper really always better?  What’s the grossest thing you’ve ever seen?  What do you need to know, is there plumbing school?  How do you know when you can’t do a job?  What equipment do you carry around?

I have only ever known medicine, you see.  I resisted at first—so typical, the Chinese kid who wants to be a doctor.  But then I volunteered to be a health aide in college—I got to move into the dorm a week early that way.  And it was inevitable, I was hooked!  So I went ‘straight through,’ as they say—biology/pre-med, no gap years, no real life working experience before medical school.

Traders, dog trainers, book editors, retail managers, accountants, nurses, call center agents, firefighters, small business owners, truck drivers, professors, musicians, actuaries—you all have such interesting lives!  One of my favorite parts of the history is when I get to hear what you do for a living, because it’s so different from my own.  So please be patient when I interrogate you about your work, I’m just so curious!  How do you spend your days?  What makes a great day for you?  What makes it hard?  What are the greatest sources of stress and meaning in your work/career/vocation?  What do you love about it?  Would you choose it again?

This curiosity stems from my deep desire to relate.  In your work, people probably present you with problems.  You apply specific expertise to diagnose the underlying condition.  You determine the most appropriate or attainable solution, and map out a path to achieve it.  You take some responsibility for the result, while recognizing that your coworkers must also participate fully for the team to succeed.  On your best days, the collaborative effort yields not only the desired outcome, but also a deepened connection between people.  It’s not so different for me.

It’s easy to perceive a distance between you and me, between patients and physicians.  Medicine can seem elitist sometimes, what with the onerous entrance exams, the stiff competition for school admission, and the prolonged and grueling training.  But in the end I bet we share more experiences than we realize.  I’m just here to use my little heap of knowledge and skills to help others, and I know that’s what you do, too.