Communication, patient-provider (photo taken from http://www.aafp.org/fpm/1999/0500/p23.html )
I was doing my usual morning rounds last tuesday when a watcher of one of my patients approached me before I saw their patient in his bed. This watcher mentioned that someone went inside their patient’s room and asked questions that raised the curiosity of the family. The watcher spoke a different dialect and though I understood most of what she’s trying to convey, she fumbled with words and was obviously concerned at the “questioning” incident. I asked about the details of the incident, but none of them can give me a clear idea what was the “questioning” all about.. All I can deduce from the watchers was that someone asked them and “implied” a question of competency and thus are worried about their decisions in seeking my care.
Unfortunately, none of the watchers asked (they are probably too shy or too gentle) the name nor remembered the identity of the person. They describe the interviewer as wearing a white dress and was asking other questions like “Why go to this hospital?” or “Who told you or referred you to this institution?”.
I asked the family then if this did affect their perception of my competency. I heard a resounding “Hindi po” or “No, it didn’t”.
I suddenly remembered who the interviewer could be. None of these watchers realized that the interviewer was actually doing a sanctioned survey. I have yet to encounter this response variance (meaning, the watcher doubted competency as a result of being interviewed) in any surveys I’ve been involved. This however pointed out one thing- a communication gap between the interviewer and the interviewee. The interviewer broke protocols by not introducing herself (blinding?) which rose suspicion and doubts on the part of the interviewee. Imagine what a simple mistake like this evoking a different response!
I felt relieved discovering this fact but was bothered by the communication gap. I spent more time explaining the survey and placate these watchers apprehensions. This time spent explaining will go a long way protecting a provider’s image from a simple neglect of introducing oneself before any patient or watcher’s interaction.
So doubts? Nah. But I’m sure that staff will have something to learn from communications 101!
injured kid..they evoke so much pain from injury largely not of their making
Of all orthopedic trauma cases I’ve worked on, my heart bleeds the most for pediatric patients. I don’t know but their helplessness and innocence always evoke this feeling of worry. Many pediatric trauma cases are often a result one adult, guardian or parents, gone remiss in guiding or understanding a child growing up. While many adults blame kids for crossing streets alone or unguided (thus running their vehicles over them), they too agree its the kids guardians or parents that really had an oversight. An irony?
Maybe. But the pediatric trauma patient is almost always a victim. Why? Imagine suffering an injury as a result of a road mishap only adults understands, or being blamed for violating traffic rules even licensed drivers rarely follow? And they wretch in pain for something they rarely know?
This is exactly why treating pediatric trauma patients entails stretching a surgeon’s patience more than you can offer any adult patient. Why adults busy themselves finger pointing on so many things, the child wretch in pain for an injury he or she rarely knew of. That is something pitiful than any other thing. Don’t you agree?
The short answer is yes, they should. Consider this:
The Philippines, a developing country, is the social networking capital of the world. It tops the list of nations who uses Facebook. Or before Facebook, Philippines also topped the list of nations using Friendster.
Social network penetration is incredibly high in the Philippines, reaching 95%. Facebook is the country’s most popular website, more so than Google, and has a penetration rate of 93.9%. The Philippines is also the eighth most popular country for Twitter use on a global scale, with a penetration rate of 16.1%. The popularity of photo sharing has increased by 46% in the country in one year, largely due to Facebook. Social networking is so popular among Filipinos, the country has been nicknamed “The Social Networking Capital of the World.” –The Ten Nations Where Facebook Rules the Internet | 24/7 Wall Street
Infographic from this site ( http://internacionalmagazine.com/2011/03/comscore-has-crowned-philippines-as-the-world%E2%80%99s-heaviest-users-of-facebook/1490/
Also, most of the other nations in the list are developing countries in Latin America and South East Asia. These social media platforms are good mediums for health education and should augment health drives using traditional media.
Medical information through the internet is readily available and fast. Most of informed patients nowadays get their medical information through the internet. Also, most of this informed patients (or their relatives, guardians etc.) also maintain a social media presence in facebook, twitter or in a blog. The multiplier effect of posting it on your facebook profile is just way beyond that can be achieve by traditonal means, like books.
Interactivity is fast, patient questions can be addressed rapidly and doubts can be clarified and , it is a good jumping off for a “real” clinic consult. The potential for improving physician-patient relationship and interactions using social media is enormous. Not taking on this opportunity simply deprive the already shortchanged health education in developing nations.
Is this enough reason for you to act now and have your social media presence be felt?
It’s hilariously difficult to even get an IV line inserted. “Jesus, are you going to pin prick me to death?“
Or get a good symptomatic history. ” I had my stomach pains and vomiting since 10:30 but I could handle it till 1:00am so you can bring me to ER” She was dehydrated by then.
They have their own diagnosis. ” I only ate small amounts of pancit…maybe its my UTI!” Maybe. But her blood sugar is also 290. With some signs of dehydration..
And their treatment : “ I’ll just lessen what I eat so as not to perk up my sugar“
And discharge plans: “I’ll go home tomorrow, where are you?“
They also can be your chief of clinics :”When are you going to see me? Who is my doctor, what time will he be here??“..
Ugh, well. I just resigned my job and endorsed my patient! I’d rather just be, “the Son”. Good luck doctor!
In all my years of practice as a physician and orthopedic surgeon, it dawned on me that I get the ultimate satisfaction from patients’ “‘smiles” at the end of their treatment program. There’s no doubt also that I get extreme satisfaction from technical masterpieces of orthopedic work that came my way during the course of my practice. But there’s none yet so far, as equally as pleasurable and satisfying as seeing your patients beaming with a smile on the last day of your rehabilitation program.
One time, when I was alighting my car on a parking space near a fast food center, I almost had a misstep after a short, muscular guy shouted, “Doc A!!!!” . The guy is sporting sunglasses, a Lakers bull cap, city shorts and tennis shoes. He was beaming with a smile and was waving his hand frantically while moving towards me. I stopped for a moment standing near the stairs, totally confused at who this stranger is coming towards me. I didn’t recognize him even if I tried so hard to remember his face. When he was an arms length away from me, he extended his right hand for a handshake and is now smiling and laughing at me. “You don’t remember me now doc?!” said this stranger. “I’m Mr. B!, the one of your patients who had this below knee amputation after that bombing incident near our marketplace, remember?” I looked down his lower extremities, I barely recognized his prosthetic leg despite the city shorts he’s wearing! “You’re Mr. B?!” I blurted surprisingly. “But you look and walk so “normal”! “Thanks to you doc. If it weren’t for your help, I’m probably be some useless person, begging my ass in the streets by now”. For a moment, I felt like a big man beaming with pride. I smiled back and offered a tight handshake and a hug.I was so damn happy he was smiling and was walking like a normal person again!
I treated Mr. B in the hospital for more than a month, trying to save a mangled lower extremity brought by an exploding improvised explosive device( IED). Undergoing several operations, I was hoping I could save a few inches more of an amputation stump, so it wont be an above knee amputation. It’s relatively easier to rehabilitate below knee amputees than patients with above knee amputations. But there’s more than to amputations and surgeries for this patient. I was trying to help a person recover from a traumatic experience and help him become functional person again, contributing to his community. I was giving him hope that even with prosthetics, even if without money for prosthetics, he’ll live a normal, life again. That was the challenge.
Together with his family, we inched our way, through rehabilitation and difficult obstacles along the way. Finances were dwindling and prosthetics are almost always costly and difficult to obtain in this part of the world. Rehabilitating patients with prosthetics is even harder. Most patients complain that it is far more eassier for them to just throw of their prosthetic leg and use crutches instead for the rest of their life. But me and Mr. B is pinning our hopes on, hope. We annoyed many agencies with our persistence – foundations, prosthetic centers, rehabilitation centers. When Mr. B finally got into an in house rehabilitation for the differently abled person, I lost contact with him for more than 6 months. He was in another place the last time we talked on the phone.
Then this unexpected meeting happened.
“You mean, you are really Mr. B?” I was asking him again and again out of disbelief. “Opo, doc!” his huge smile is most viral. I can see the very happy, lively and “normal” guy in him now. It was as if nothing happened in the past. This guy, who was at the brink of depression months ago, is one very happy, one very normal person again.
I tell Mr. B’s story to all my patients who are at the brink surrendering to their afflictions. He even serve as a model for my patients that has had amputations. Even such traumatic experience couldn’t erase one of man’s hallmark of ” humanity”- hope.
As for me, I smile with pride and confidence telling this story to all my other patients. I always take pride in my patient’s stories of hope and how’d they’d live through years despite their predicaments. That was always my mantra in this profession. Hope for my patients, smiles in their heart. I’d be one very happy doctor if I can at the very least achieve that…
Lift your head, baby, don’t be scared
Of the things that could go wrong along the way
You’ll get by with a smile
You can’t win at everything but you can try. “With A smile, Eraserheads”
