What I Wasn’t Taught At Medical School – Lesson 1
The questions you ask in a doctor’s room matter
The Art of Doctoring November 23, 2020
If you’re feeling grumpy, try this trick
The Art of Doctoring February 10, 2020
Photo by Nik Shuliahin on Unsplash
Where are your finger prints in my care?
Lean Medicine May 27, 2019
It is unlikely that you will be part of every encounter with the customer, client or patient whatever you do and wherever you work. A barista is not at the table with the customer is presented with their breakfast; a dressmaker isn’t at the checkout when the customer makes their purchase at a department store. Sooner or later you won’t be there in person. However it is likely that whatever you’ve contributed will have an impact. How do you define your role from this perspective in healthcare?
The participants—21 family physicians (fps), 15 surgeons, 12 medical oncologists, 6 radiation oncologists, and 4 general practitioners in oncology—were asked to describe both the role that fps currently play and the role that, in their opinion, fps should play in the future care of cancer patients across the cancer continuum. Participants identified 3 key roles: coordinating cancer care, managing comorbidities, and providing psychosocial care to patients and their families. However, fps and specialists discussed many challenges that prevent fps from fully performing those roles:
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The fps described communication problems resulting from not being kept “in the loop” because they weren’t copied on patient reports and also the lack of clearly defined roles for all the various health care providers involved in providing care to cancer patients.
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The specialists expressed concerns about a lack of patient access to fp care, leaving specialists to fill the care gaps. Easley et al
Do something in your power to make a difference
Lean Medicine May 22, 2019
It’s a small detail. If you are accompanying someone down a corridor as a healthcare professional- don’t stride ahead. Ideally walk alongside the person or let them lead the way if they know where you are headed. If they are wheeling a buggy and carrying a bag offer to help by wheeling the buggy. Just try it. You might like how they respond. Apart from that you can learn so much about the person even before the consultation begins:
So instead of a doctor assessing a patient’s blood pressure, body mass index, chronic conditions, hospitalization and smoking history and use of mobility aids to estimate survival, a lab assistant could simply time the patient walking a few meters and predict just as accurately the person’s likelihood of living five or 10 more years—as well as a median life expectancy. Scientific American
Quitting work may be the best thing you can do
Lean Medicine March 25, 2019
Do you quit work? At least until it’s time to be back in the office, clinic, shop or hospital? Are you constantly taking calls and texts from work even on vacation?
Recreational travel may increase creativity by relieving workers from stress, providing diversifying experiences and increasing positive emotions. Consequently, vacations may boost creativity, apparent in a greater variety (flexibility) and originality of ideas after work resumption. de Bloom et al
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What did you expect yesterday?
Lean Medicine March 22, 2019
As you walked through the front doors at work yesterday what were your expectations? Were you hoping:
- To serve to the best of your ability
- To learn something new
- To enjoy good company doing something meaningful
- To make a difference to someone
- To earn a big pay cheque
- To pass the time before home time
- Something else?
Which was it? How did you feel at the end of the day? How do you think those who interacted with you felt at the end of the day?
Picture by Gotcredit
Do you see how that happened?
Lean Medicine March 19, 2019
You may face may challenges or have an unexpected outcome following your interaction with your customer, client or patient. As a healthcare professional these are opportunities to reflect on how an event unfolded, how you were feeling at the time and how you are feeling afterwards. Consider then how those emotions play out through the course of the day. Given that most outcomes in healthcare are moderated by an interaction with a health professional it is important to ensure that the health professional is attuned to their inner world. We can’t change many things as providers of health services but we can look within.
Know what causes your negative emotions, and which types of feelings you face most often. When those emotions begin to appear, immediately start your strategy to interrupt the cycle. The longer you wait, the harder it will be to pull yourself away from negative thinking. Mindtools
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Do you perform any rituals when you consult?
Lean Medicine March 13, 2019
Before a surgeon gets anywhere near a patient in the operating theatre he must wash his hands, put on a gown and gloves. He then drapes the patient and cleans the skin. As he makes his first incision there is no mobile phone on the table, he banishes all distractions and appreciates that the job isn’t over until he has sutured the wound. Whatever you do for a living how do you approach the job? If you adopted rituals would you perform better? Bacteria can destroy a surgeons work. What contaminates your work and how does that manifest in your results?
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What don’t people tell their doctor?
Lean Medicine March 12, 2019
Do you know why your customer, client or patient chose you today? If you are his doctor John made an appointment this morning because he thinks he may have an inherited illness. His uncle recently died from this condition and it all started with weakness in his arm. John has noticed that he has pain and weakness in his right arm when he lifts heavy things at work. This morning he nearly dropped the kettle when making a cup of tea. He isn’t going to tell you what he is worried about but he expects you will tell him he doesn’t have that condition after all the tests you will perform right? His uncle had lots of blood tests and scans.
In quite a number of contacts with a new reason for an encounter (22%), the ideas, concerns, or expectations of the patient remain undisclosed. A second main finding is that the expression of concerns and/or expectations is correlated with fewer prescriptions (univariate, logistic regression analysis, and also after exclusion of patients without an ‘a priori need for medication’). Although the causal relationship remains uncertain, the observations may indicate that systematically disclosing the patients’ real expectations and concerns could lead to less medication use. Matthys et al
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