Cast & Curious

Tag: Medicine

  • The Doctor is In, Love: How health professionals balance love and work

    People in different professions deal with work related pressures, fatigue, and challenges. The medical profession is one such field. Recent studies have shown the detrimental effects of extended work hours to the professional’s mental health and personal well being. Although stories abound, the effects of work related pressures on the personal relationships of health professionals is still a controversy.

    As in any profession, there are perceived advantages and disadvantages of going into an intimate relationship with a health professional. In the medical profession, what constitute a life enhancing, long lasting or nurturing intimate personal relationship at least controversial. Even health professionals don’t agree on what constitute a successful, life enhancing or nurturing relationship!

    T1. As a health professional, what defines a life enhancing, intimate relationship for you?

    Our society often demand almost superhuman performance on health professionals, that sometimes intimate relationships suffers. The extended work hours for example, often eats up on time intended for our personal relationships. The objective, emphatic but emotionally protective way of communicating by healthcare professionals at work often backfires when applied to interpersonal, intimate relationships.

    T2. What work related factors affect the intimate, personal relationships of medical professionals?

    How health professionals balance their personal and professional life is an art itself. More so with intimate relationships. By experience, it has never been easy. Tipping the balance either way may wreak havoc on the other or worse, destroy both. There are numerous, often funny and sometimes scary anecdotes of health professional’s “love life” gone awry. The demands of healthcare profession is often blamed, although early stage recognition of attributing factors is never even considered. As in work, early diagnosis and “treatment” could have save a potential life enhancing intimate relationship. What constitute “treatment” for a failing health professionals intimate personal relationship is another practice guidelines we have yet to develop.

    T3. As a health professional, what coping mechanism have you employed to nurture a life enhancing, intimate relationship?

    How health professionals cope with the demands of work and sustain a life enhancing intimate personal relationship is the topic of our chat this Saturday, February 15, 9 PM Manila time. Join us in our #healthXPh tweet chat!

    Image by Gerd Altmann from Pixabay

  • The Pursuit of Happiness in Healthcare Workplace

    “Mam, where’s our patient?!” As the OR nurse calmly enumerated a litany of reasons why our patient isn’t yet on the table as scheduled, I’m welling up with frustration. “Excuse me” I said. I silently went back to the empty OR dressing room. I threw a one-two punch -high kick in the air, closed my eyes, took a deep breath and sat momentarily. Grabbing my hospital coat, I went to the patients room, talked to the patient and tried fixing whatever I could, so the patient can have the procedure on a later time. I did that with all the warm smile I could muster. Deep inside? I was screaming for reason. “Am I still happy doing all these, despite the challenges?”

    The news and internet is teaming with bleak stories of healthcare workers worsening mental health, burnout and job satisfaction. WHO recently updated its definition of burnout:

    Burn-out is a syndrome conceptualised as resulting from chronic workplace stress that has not been successfully managed. It is characterised by three dimensions: (1) feelings of energy depletion or exhaustion; (2) increased mental distance from one’s job, or feelings of negativism or cynicism related to one’s job; and (3) reduced professional efficacy. Burn-out refers specifically to phenomena in the occupational context and should not be applied to describe experiences in other areas of life.

    WHO, 2019

    Evidence points to a staggering 1 in 2 healthcare workers has had or is experiencing burnout. Yes thats 50% of health workers! Burnout evidently affects health professional mental status and is tied to job satisfaction according to recent studies.

    T1. Have you experienced or is experiencing burnout in the healthcare workplace? Please describe.

    Don’t get me wrong. I’m not turning a blind eye to the systemic problems besetting the health care industry. The causes of health workers burnout are multifactorial and systemic.

    Work system factors of the systems model of clinician burnout and
    professional well-being.

    I am for systemic solutions and we need it yesterday, or maybe five years ago. But while our health leaders are drafting solutions, we’re left to cope with burnout and find happiness in an adverse workplace. By that I mean, finding happiness on a personal level, cherry picking “tips and tricks” to cope with burnout, perform above par at and still appreciate the career we so love doing. It’s not unusual nowadays to be approached by a colleague asking “How do you find happiness in this shit hole of a workplace?!” Cynical, but a very positive way of looking for happiness in the chaotic sea of workplace challenges.

    T2. How do you find happiness in your healthcare workplace? Please elaborate.

    Systemic solution are often innovative to induce radical changes in the health care industry. The US National Academy of Medicine came up with a systems framework for addressing health professionals mental well being. I’m hopeful our health leaders will get their acts together and come up solutions to this problem. These solution need to trickle down to the grass root health workers fast. By fast, I mean five years ago. In the meantime, we’re left to cope with burnout and find happiness in the workplace. If these personal “tip and trick” miraculously worked for us, we happily share it to our colleagues and sometimes with our bosses or managers.

    T3. What workplace happiness would you share to a colleague or even to your boss and managers?

    Join #HealthXPh tweet chat this Saturday 9PM Manila time as we discuss coping with health professions burnout by finding happiness in what we do. This should guide you through the discussions:

    • T1. As a health professional/student, have you experienced or is experiencing burnout in the workplace? How did you cope up with it?
    • T2. As a health professional/ student, how do you find happiness in your workplace?
    • T3. What workplace happiness would you share to a colleague or even to you boss and managers?

    See you all on Saturday!

    References:

    National Academies of Sciences, Engineering, and Medicine. 2019. Taking Action Against Clinician Burnout: A Systems Approach to Professional Well-Being. Washington, DC: The National Academies Press. https://doi.org/10.17226/25521.

    Shanafelt TD , Balch CM ,  Bechamps GJ , et al . 2009. Burnout and career satisfaction among American surgeons. Ann Surg 2009;250:107 15. doi:10.1097/SLA.0b013e3181ac4dfd

    Rosales, Rheajane & Labrague, Leodoro & Rosales, Gilbey. (2013). Nurses’ Job satisfaction and Burnout : Is there a Connection?. International Journal of Advanced Nursing Studies. 2. 10.14419/ijans.v2i1.583.

    Jabonete, Fritz Gerald & Dayrit, Aubrey. (2018). Reported Work-related Stressors among Staff Nurses in Metro Manila, Philippines.

    #HCLDR. (2019, December 5). Reconnecting To Joy in Work [Blog post]. Retrieved from https://hcldr.wordpress.com/2019/12/05/reconnecting-to-joy-in-work/

    Credit: Image by Halcyon Marine Healthcare Systems from Pixabay

  • Five important reasons why health leaders need social media

    Like it or not, internet and social media are part of today’s health environment. Understanding social media is key to surviving this environment. Flexible leaders harness social media to meet better health care experience for patients. Here are the five important reasons why health leaders need to learn and harness social media:

    1. A social media post made you or your institution (in)famous.

    Most unfortunate route to learning the ropes of social media. Many health leaders stumbled social media this way. Its never too late though. Stay calm. Plan a prompt, well thought out social media response strategy.

    2. You’re not health information’s sole gatekeepers anymore thanks to internet and social media.

    Gatekeepers hold the key to information and provisions of care in the 20th century. That’s not the case in this generation. Health information is accessible to many people. Some patients wants greater participation in managing their health. Fortunately, a health professional- patient partnership is not only feasible via social media. The partnership showed better health outcomes in some areas, while lowering cost of delivery in others.

    3. Your value system is in conflict with the new value system arising from internet and social media empowered generation.

    New value system with internet and social media

    We’ve hone our leadership skills and toolboxes before internet and social media. Radical transparency a value the current generation espouse, annoys many leaders. Understanding this new value system is key to providing better health care outcomes, at a reduced cost for this generation.

    4. New and social media amplified health expectations is different from what existing system provides.

    Patients expect better healthcare experience

    With readily available information and new value system comes new health care expectations. Unmet health expectations lead to clashes and divorce in health partnerships. Fragmented health systems called silos, provide irrelevant care at skyrocketing cost.

    5. Patients and their support group wanted greater participation in managing their health.

    Internet and social media made health information accessible to everyone. Providing care though, is still in the hands of trained professionals. This may not be the case for long as many patients including their family and support groups, wanted greater participation in managing their health. It’s no surprise that social media is the platform of choice. The sooner we accept this, the better prepared we are in harnessing social media for better health care.

    Social media is here to stay. I may have painted a bleak picture but there’s a way to harness social media for better health. Leaders should be flexible enough to partner with patients in this regard. It is their health after all.

  • Effective healthcare campaigns in changing digital media environment- From “You do it” to “Let’s do it!

    Vaccination and measles outbreak flooded our social media feeds recently. The sad news is we thought we eradicated measles decades ago. Measles however, only hogged the media limelight after an outbreak happened. “What went wrong with the measles campaign?” many asked. There’s no shortage of blaming on what many called “a failure” to counter an “avalanche of online misinformation” about vaccination and vaccines. Measles and vaccinations are just two of the many health campaigns that took centerstage after an “outbreak” happened. Heard of health supplements? Alternative cancer treatments? Dengue? Flu? Smoking? Vaping? Diabetes? Kidney diseases? We din’t notice until something alarming happened. We blame the new media and the people who use it for their own purposes-good or bad. Then we rush to using the same new media to counter such online misinformation. We fail and wonder. How come?

    First allow me to narrow the discussion to health campaigns on social media. Successful health campaigns are not solely because of an effective media strategy let alone a savvy social media leader. The whole caboodles of political, economic, logistical and support systems should be in place before we can even talk of launching it on social media. Having said that, and for the sake of our discussion, lets assume we all have those factors sorted out in place and we’re left with an effective social media campaign strategy to go with the health advocacy.

    In the past we had leaders adept in using media to implement effective healthcare campaigns. Think Dr. Juan Flavier and his much loved health news, radio and TV campaigns. He and his health campaigns were blockbusters, to his avid followers and critics alike. The charismatic secretary seemed to have mastered old media messaging and signalling and was very effective in mobilizing the crowd. He is interested in empowering the public, not himself nor his organization- a novel, laudable new media value. This cascading top to bottom healthcare campaign strategy worked for old media- newspapers, radio and TV. Will it work for the new media?

    T1. What old media health campaign strategies work in social media?

    Internet and social media showed much promise for advocacies and campaigns. Twitter had been instrumental in monitoring or reporting disease outbreaks for CDC and WHO. Healthcare organizations employed social media platforms to pressure health policy changes in some countries, and won. Social media campaigns played a huge part in the passage of Sin Tax Law and the Universal Healthcare Law in the Philippines. Incremental wins some may call it but a win nonetheless. Let’s not forget, the millions of money that poured in to health advocacy groups because of memes such as the “Ice bucket Challenge”. Why some organisations are successful in using social media to meet the objectives of their healthcare campaigns (and others, do not) remains a mystery to many.

    Internet and social media comprise the “new media”. Internet gatekeepers and social media platforms keep changing its policies, algorithm and strategies to achieve its bottomline- profit for its owners and shareholders. That’s not altogether bad given the social media platforms who succeeded in providing desirable value to the general public while maintaining a profitable and sustainable business model. That social media is hog washed in false information and dubious health messages is also not true. There’s no dearth of superior quality health information online according to Keselman (2019). Despite the presence of superior quality and credible online health information, some health campaigns failed to mobilize a hyperconnected populace. Why did it fail? Was it the messaging? Platform? Theme?

    T2. What are the reasons behind the failure of some health social media campaigns to mobilize the crowd and effect change?

    In their book New Power: How Power Works in Our Hyperconnected World- and How to Make It Work for You, Heimans and Timms (2018) placed leadership archetypes into a spectrum, a quadrant on how leadership structures (termed old/new power) use old/new power values to effect change.

    Leadership Archetypes in a quadrant with examples of leaders/organizations who best exemplifies each quadrant. Image from HBR article here https://hbr.org/2014/12/understanding-new-power

    Arguably, the top down, cascading model of social media campaigns don’t work effectively in digital social media environment.

    Old versus new power values. Image from HBR article here https://hbr.org/2014/12/understanding-new-power

    The “I’m the expert just follow what I say” seem to be a less appealing to social media crowd than that of the “bottoms up, grassroots or collaborative approach. The new leadership model committed to empowering the crowd with new power values are the most successful ones. Values like collaboration, radical transparency, maker mentality and overall general participation characterise this new power value. Social media smacks right into the heart of these new power values. Leaders who are adept at these new power values empower and mobilize the crowd .

    T3. What best strategy can you advise health leaders in using social media to mobilize and effect change in healthcare?

    Thankfully, many organisations (old and new power structures alike) are restructuring, recalibrating their health campaigns to align with the intricacies of new power tools, like social media. That is something we can learn from this deluge of disease outbreaks and health misinformation. This is the topic of this #HealthXPh chat come February 9, 2019 9PM Manila time as we build consensus of how to’s in implementing health social media campaigns that empowers and mobilizes the crowd.

    Join #healthXPh chat with these guide questions in mind:

    • T1. What old media health campaign strategies work in social media?
    • T2. Why did some social media campaigns failed to mobilize the crowd and effect change in healthcare?
    • T3. What best social media strategy will you advise health leaders in mobilising and effecting changes in healthcare?

    References:

    • Keselman A, Arnott Smith C, Murcko AC, Kaufman DR (2019) Evaluating the Quality of Health Information in a Changing Digital Ecosystem J Med Internet Res 2019;21(2):e11129 URL: https://www.jmir.org/2019/2/e11129
    • Sak,G; Diviani, N; Allam, A; Schulz, P: (2016) Comparing the Quality of Pro- and Anti-vaccination Online InformationA Content Analysis of Vaccination-Related Webpages BMC Public Health. 2016;16(38) 
    • Heimans, J; Timms, H. (2014) “Understanding “New Power””. Harvard Business Review. December 2014.
    • Heimans, J; Timms, H. (2018) New Power: How Power Works in Our Hyperconnected World- and How to Make It Work for You. New York, Penguin Random House LLC

  • Strategies and technologies healthcare professionals use for learning

    Why are you still studying? Are the years of medical school and training not enough?

    Barely an hour before writing this post, a neighbour knocked on my door asking if I could look at his 9 months old nephew. His nephew is weak, have an on and off fever for a week, and is vomiting since this morning. “Your nephew is dehydrated” I said. “Bring him to the nearest hospital now. ” I couldn’t remember the last time I managed a pediatric acute gastroenteritis. As an orthopedic surgeon, I rarely deal with such cases unless one of my family member contracts the disease. Even then, I rarely manage pediatric AGE.

    This is why healthcare professionals need to continually learn even after med school and training. You’ll never know what disease or which patient will come “knocking” on your door. Besides, many of us tend to forget clinical skills we haven’t use for some time. Society also expect us to be competent practitioners, irregardless of the specialised field you’re into. My neighbour for example, believed I’m competent in managing pediatric AGE, despite him knowing I’m an orthopedic surgeon for years!

    Learning also benefits us and our patients even in our narrow fields of practice. Learning is a moral and ethical responsibility embedded in the many oaths we took entering this profession.
    The ever changing landscape of diseases, research findings, healthcare issues and clinical management skills favours health professionals who consistently learn or upgrade their knowledge and skills. The information explosion and affordances of new technologies might also help us cure some disease, alleviate the ills or empathise with our patients. Simply put, we need to continually learn for our patients.

    T1. What inspires you to learn?

    We learn for our patients, but we are the learner. Society expects healthcare professionals to be lifelong learners- perpetually proficient and competent in the medical field. In practice, our learning environment shifts from formal school to include, informal, out of school, face to face, at a distance or a mix of all these. Different environments have varying nuances for learning. Some strategies work best for a certain learning environment. Most of us couldn’t simply drop our professional practice to go back to formal school. We have to find other ways learning befitting four learning or practice context.

    T2. What is your strategy for learning?

    While we use many similar technologies for learning across these different contexts, recent technologies afforded us newer non traditional ways of learning. Online technologies for example allowed us to learn without leaving our practice. With appropriate technologies, we can now choose when, how and where to learn. Feedly for example allows me to aggregate, curate and organize medical information efficiently.

    T3. What technologies do you use for learning?

    As healthcare professionals, patients inspire us most to continuously learn. When our learning shifts from formal school alone to include many other environments, we must be able to examine and employ strategies and then find appropriate technologies to maximize learning. It is then that “we direct ” or take control of our own learning.

    In this November 10, 2018 9PM Manila time #HealthXPh chat, we will explore paradigms and technologies by which healthcare professionals learn today. By paradigm I mean a theory, a strategy, a method or “lens” by which we anchor what and how we learn. Technologies refer to any tool, mainstream or emergent that you use to learn or maximize learning. These are our guide questions:

    • T1. What inspires you to learn?
    • T2. What is your strategy for learning?
    • T3. What technologies do you use for learning?

    (If you want to learn more about my paradigm of learning and technologies I use to support it, read this article)