Talking with my wife last night, we got on the topic of doctors and the healthcare system. Of course in our house, that is NOT uncommon, but this time it was different. We were talking about how the medical community sometimes appears to play the "guessing game" when it comes to patient care. More specifically, how it relates to friends and family with medical issues.
Patients do NOT want to hear that doctors are sometimes uncertain about their condition or treatment options. But this is the TRUTH...there are times when a doctor uses their training as well as their gut feelings to make clinical decisions. Unfortunately, we (doctors) only have so much research and clinical information to support certain treatments.
At some point, there is the "Well, let's try this and see what happens." mentality. I understand that for patients, that sounds awful. That sounds like you are a test dummy...you're NOT. Let me ASSURE you that your healthcare is not a complete guessing game, there is clinical reasoning and sound research to support many of the decisions being made in hospitals and clinics all over the country. However, that is why we refer to the PRACTICE of medicine and ask questions like "How long have you been in PRACTICE?" and "What is your PRACTICE speciality?".
As a society, we have this unfortunate preconception that clinicians ALWAYS know what is best. While I can confidently say that I frequently understand the best approach to patient conditions, this is not ALWAYS the case...And I think quality physicians will agree.
Doctors are NOT omnipotent, we do NOT know everything about everything.
Patients SHOULD QUESTION doctors when things seem unclear. Ask for explanations and clarifications regarding the situation. Quality doctors should take time to explain, clarify and even provide documentation supporting their clinical decision making process. This clearly requires clinicians to be "up-front" with their patients, especially during times when the unknown
Hopefully if you have questions next time you are with your doctor, you will feel more inclined to ASK them...
Clinicians should be:
- Confident yet Humble
- Knowledgeable yet Aware of their Limitations
- Scientific yet Compassionate
- Intelligent yet Open-minded
After all, we are all human beings, capable of making mistakes.
of my direct-pay practice: KEEP THINGS SIMPLE, BRING HEALTHCARE BACK TO THE PATIENT BY PROVIDING QUALITY CARE.
Podcast Interview (yes, another audio clip for you):http://traffic.libsyn.com/survivinghealthcare/The_journey_from_an_insurance_based_practice_to_direct_pay_with_Dr_Erik_Korzen.mp3
"So why don't you accept my health insurance?"
I get this question a lot, and it's totally OK. I understand and I actually feel the same way at times. Can we just agree on one thing? We live in a time with an extremely complex healthcare system
. (it does NOT need to be that way, but that discussion is for another time)
Your health and the care of it should be about YOU. And really, all healthcare should be that way, right? Then managed care companies (your insurance) gets involved. This is referred to as managed care because someone other than yourself and your doctor are MANAGING YOUR CARE. This is really not patient-centered care.
At the center of everything I do is the PATIENT
My entire basis for my practice when I opened back in November 2014 was to just keep it simple. This means that although I obviously need to pay my own bills to keep my doors open, I can use more of my energy to focus on the patient's needs. There is no 'excessive documentation to prove to some faceless person in an office somewhere that the care I am providing is considered necessary'.
I will be up-front and straightforward with you. If I think I can help, I will offer my services. If I believe you need something other than what I can offer, let's get you that care. Personal relationship, good communication and empathy...it should really be that simple.
Check out my recent interview on Surviving Healthcare Podcast, also available on iTunes. Just click the link to listen to the audio clip directly or click the podcast logo at the bottom. Share with your friends!http://traffic.libsyn.com/survivinghealthcare/The_journey_from_an_insurance_based_practice_to_direct_pay_with_Dr_Erik_Korzen.mp3
of my direct-pay (cash) practice: KEEP THINGS SIMPLE, BRING HEALTHCARE BACK TO THE PATIENT BY PROVIDING QUALITY CARE.
The doctor-patient relationship...WHERE DID IT GO?
We are in a period of rapidly changing healthcare. From the use of more diagnostic tests TO insurance requirements TO electronic medical records, there is significantly less 1 on 1 time with your doctor.
Does it feel like your doctor is rushing you? Is your doctor focused on you, another patient, the computer, their own income or documentation?
What happened to someone actually taking time for another person, especially if that person is in pain?
There are numerous research studies focusing on the doctor-patient relationship, with varying aspects considered. One of the most commonly discussed topics is how quickly a doctor interrupts a patient. On average, it takes about 10-30 seconds.
10-30 seconds of YOU telling the doctor what is going on before they interrupt you.
Regardless of the condition, high blood pressure or knee pain, 10-30 seconds is a very short amount of time. This equates to essentially a few sentences that a patient can verbalize before being interrupted.
Beyond just the interruption time, what about common sense and compassion?
If we as healthcare professionals simply slowed down our thought processes, there would most likely be happier patients with better clinical results...which is obviously the point of HEALTHCARE. Slowing down thinking sounds counter-intuitive, but I should re-phrase this to "RE-FOCUS our thinking".
I see a similar situation occur when my students take the CADAVER lab exam. To give you an idea of how this works, the student walks up to a cadaver with 4 separate tagged structures and has 3 minutes and 45 seconds to write their answers down before the signal to move to the next cadaver sounds. An ENTIRE cadaver is in front of the student and probably a million different terms and memorization aids are streaming through their brain. Instead of getting caught up in these DETAILS and COMPLEXITY, the student needs to SIMPLIFY: quickly FOCUS on the tagged structure, read the question pertaining to it, observe other relevant anatomy and finally RE-FOCUS on the structure to write the appropriate answer. It is really THAT SIMPLE, students should STOP, THINK, and PROCESS... Instead, most students STOP, FOCUS HEAVILY on ONE concept, and MISS important clues...
Right Lower Trapezius muscle on cadaver
I believe that a similar situation occurs between a doctor and patient.
Obviously this is not the EXACT same thing, but bear with me...
Doctors begin interacting with a patient, FOCUS on ONE concept, MISS possibly important indications for other conditions, and are DONE.
I am guilty of interrupting, focusing too heavily on ONE concept and moving on to the next thing. Next time you are in my office or another clinician's office, please understand we too have faults. Human fallibility cannot be un-trained or educated out of us, it is human to make mistakes.
However, healthcare professionals can and should be conscious of the sometimes deplorable patient interaction. I understand we are all very busy people, but licensed healthcare professionals have a code of ethics to uphold when it comes to clinical encounters. When you feel like you are not being heard by your doctor OR being rushed to get to the point, calmly remind the clinician that you would like to get to the core of the problem and spend a little time developing a trusting relationship.
Have a great week everyone!
The Surviving Healthcare podcast
is a compilation of podcast interviews with the focus of shedding light on the broken
healthcare system in this country. After talking with Andrew (the host) a couple months ago about the chiropractic field, we decided to conduct a recorded interview
Even though Andrew clearly has a background in healthcare and is exposed to a wide array of topics through his own podcast, much of the chiropractic field is a mystery
. I think this is the case for a lot of other medical providers
(your PCP, orthopedist, neurologist, pediatrician, OB/Gyn, etc...) as well as potential patients.
So what do we do?
We start by spreading the word to the masses. This means exposing as many people to this paradigm shift as possible.
Tell others about this podcast interview or this blog. NOT to increase referrals to my practice BUT to benefit the entire group of chiropractors that practice evidence-based care. (like some colleagues found through the Forward Thinking Chiropractic Alliance
Changing the face of chiropractic is by no means an easy process.
In future posts, I may get into the details of what re-defining this profession specifically looks like. Stricter entrance standards? YES! Entrance exam similar to MCAT? YES! Quality Residency programs? YES!
There will people that disagree with me, even in my own profession. Unfortunately, in order to progress we must ruffle some feathers
. Nothing ground breaking has ever occurred, no large social shifts or mindset changes, without challenging the status quo.
Come along for the ride!
Click the link above
for my podcast interview to learn more. Below are the links if you want to copy/paste to someone as well. You can also find this interview via iTunes under Surviving Healthcare.