Does anyone else think that the change from summer to autumn is the most drastic of the seasonal changes we experience?
I was driving late yesterday afternoon and I could not help but be struck at the "all of a sudden" differences I saw and felt as I made my way home. A sea of red tail lights from the traffic slowly moving with me stood out in contrast to the wave of white headlights approaching from the opposite direction....it was barely 4 pm. Surrounding us all, dusk, with its rich hues of purple created by the sun setting through both thick and thin cloud layers, rapidly disappeared as night fell.
The busy surface streets, lined with shopping centers, brilliantly lit with a variety of colored lights displaying restaurant names, gas stations, grocery stores and pharmacies, became brighter as the darkness increased. Residential neighborhoods, illuminated by streetlights, were also starting to glow as residents turned on lights both inside and outside their homes.
Here and there people dressed in light coats and hats -- resilent North-westerners armed with an umbrella, a flashlight or a dog, walked along the sidewalks not bothered by the occasional drizzle. Some, the more athletically determined I suppose, dressed in running shorts and shirts, passed and out distanced the walkers with their rhythmic and almost effortless strides. Still the darkness silently enveloped us.
This growing lack of light did not stop many people from continuing their work-related activities either, be that yard clean up, garage cleaning, or in many instances, putting up Christmas decorations. Yes, Christmas decorations. As November moves out and December moves in, we enter the Holiday Trifecta: Thanksgiving, Christmas and New Year's celebrations.
What happened to those long, lazy days of spring and summer? The hours of daylight beginning around 5 am and lingering until 9 pm or later? Not that I utilized the gift, mind you, but that flexibility to be able to be outside to enjoy a sunrise or a sunset was sort of always there should I make use of the opportunity. The busyness of the days, it seemed, could begin or settle like waves gently lapping on the shore.
The shortened days of autumn and winter -- especially as the year closes -- bring an almost frantic state of mind as the holiday activities loom ever-closer on the daily horizon. Morning light delays its arrival which means I am less inclined to move from the warmth and reverie of bed. Once up and moving, the race to complete daily tasks before early sunsets is much more like trying to get to safety as waves crash the shore ahead of a coastal storm. The added holiday activities, simple ones, really, like decorating our home, the office, just seem to add to the frenzy.
It really is an interesting contrast that we talk about the "lazy" days of spring and summer, in spite of the fact that the days appear longer; while the shortened days of autumn and early winter are crammed with activity that puts an ant farm to shame. It is the same 24 hours. Nothing more. Nothing less. The challenge is making the most of the daily gift we are freely given, which for me means getting out of the mind-game of light and darkness and just doing what needs to be done.
Friday, November 25, 2016
Thursday, November 17, 2016
In the Clinic Building Relationships
Remember the scene in You've Got Mail when Joe Fox (Tom Hanks), having put Kathleen Kelly (Meg Ryan) out of business, visits her after learning that she is sick, and the conversation turns to relationships? The conversation went like this:
Joe Fox: It wasn't...personal.
Kathleen Kelly: What is that supposed to mean? I am so sick of that. All that means is that it wasn't personal to you. But is was personal to me. It's "personal" to a lot of people. And what's so wrong with being personal, anyway?
Joe Fox: Uh, nothing.
Kathleen Kelly: Whatever else anything is, it ought to begin by being personal.
This is at the heart of all things....being personal. In the clinic we see this every day. Going to the doctor is of all things personal, right? Patients new to the practices may, in a matter of a half hour's acquaintance, be asked to get undressed or otherwise expose parts of their body to near strangers....zooming from, "Nice to meet you," to "Let's take a look at that sore on your___________. Would you please take off your shirt and pants?" Pretty darn personal.
In today's healthcare culture, the trend seems to be heavily focused on the "science" of medicine. We are blessed to be living in an age where technology advances enable practitioners to identify with greater clarity not only a patient's medical problem or condition, but also hone in on the severity of the condition. A cough can be a cough, or it can be the symptom of something more serious, which might be identified by imaging studies. The ability to use this technology gives medical doctors information that helps them better treat their patients' medical problems. It seems that the advances in both technology and drug therapy should improve the quality of medicine. Or not.
Certainly the ability to diagnose and treat conditions has improved and lives are saved, for which we should be grateful. The price paid for these advances can have an unseen but perhaps a negative effect. We see this every day in the clinic: Imaging reports from X-rays, CT, MRI tests, lab results and consult reports flood the office fax machine, mail, and email. Our providers spend much time each day reviewing data and planning the next steps in treating the patients who come through our doors. Ours is a small office; I can only imagine what the larger clinics must see, and wonder how the providers deal with the tsunami of paperwork in a practice panel of 2000 or more patients. Time consuming tasks that either bring the provider into the office hours ahead of clinic time to complete, or keep them hours beyond the time the clinic closes can negatively impact both quality and work satisfaction.
All the paperwork and reports needing to be completed for specialist referrals, insurance companies and the government pull doctors, therapists, counselors away from the "art" of medicine; the intangible something that should really be at the heart of working in a medical setting. Asking a physician or nurse why they chose the profession, the most common answer is not because they enjoy reading medical test results, completing forms to justify medical treatment for a patient, or even the money. The most common reason, almost to a person, is that they want to serve others by using their knowledge and skill to improve their patients' health and wellbeing, to treat them when they are not feeling well and to be there ready to help when needed.
So for what it is worth, patients don't know or remember that our doctors spend a great deal of time behind the scenes shuffling papers and jumping through hoops to get services or prescriptions needed in patient treatment. This is science and now bureauracy of medicine. Patients do know and remember, though, how they felt after seeing the doctor; the time spent in conversation with them; the caring touch received on physical examination or even in a handshake or hug; the tone of their voice; a smile. This is the art of medicine. It is building the relationship and feeling valued. It begins, grows and thrives by first being personal.
Joe Fox: It wasn't...personal.
Kathleen Kelly: What is that supposed to mean? I am so sick of that. All that means is that it wasn't personal to you. But is was personal to me. It's "personal" to a lot of people. And what's so wrong with being personal, anyway?
Joe Fox: Uh, nothing.
Kathleen Kelly: Whatever else anything is, it ought to begin by being personal.
This is at the heart of all things....being personal. In the clinic we see this every day. Going to the doctor is of all things personal, right? Patients new to the practices may, in a matter of a half hour's acquaintance, be asked to get undressed or otherwise expose parts of their body to near strangers....zooming from, "Nice to meet you," to "Let's take a look at that sore on your___________. Would you please take off your shirt and pants?" Pretty darn personal.
In today's healthcare culture, the trend seems to be heavily focused on the "science" of medicine. We are blessed to be living in an age where technology advances enable practitioners to identify with greater clarity not only a patient's medical problem or condition, but also hone in on the severity of the condition. A cough can be a cough, or it can be the symptom of something more serious, which might be identified by imaging studies. The ability to use this technology gives medical doctors information that helps them better treat their patients' medical problems. It seems that the advances in both technology and drug therapy should improve the quality of medicine. Or not.
Certainly the ability to diagnose and treat conditions has improved and lives are saved, for which we should be grateful. The price paid for these advances can have an unseen but perhaps a negative effect. We see this every day in the clinic: Imaging reports from X-rays, CT, MRI tests, lab results and consult reports flood the office fax machine, mail, and email. Our providers spend much time each day reviewing data and planning the next steps in treating the patients who come through our doors. Ours is a small office; I can only imagine what the larger clinics must see, and wonder how the providers deal with the tsunami of paperwork in a practice panel of 2000 or more patients. Time consuming tasks that either bring the provider into the office hours ahead of clinic time to complete, or keep them hours beyond the time the clinic closes can negatively impact both quality and work satisfaction.
All the paperwork and reports needing to be completed for specialist referrals, insurance companies and the government pull doctors, therapists, counselors away from the "art" of medicine; the intangible something that should really be at the heart of working in a medical setting. Asking a physician or nurse why they chose the profession, the most common answer is not because they enjoy reading medical test results, completing forms to justify medical treatment for a patient, or even the money. The most common reason, almost to a person, is that they want to serve others by using their knowledge and skill to improve their patients' health and wellbeing, to treat them when they are not feeling well and to be there ready to help when needed.
So for what it is worth, patients don't know or remember that our doctors spend a great deal of time behind the scenes shuffling papers and jumping through hoops to get services or prescriptions needed in patient treatment. This is science and now bureauracy of medicine. Patients do know and remember, though, how they felt after seeing the doctor; the time spent in conversation with them; the caring touch received on physical examination or even in a handshake or hug; the tone of their voice; a smile. This is the art of medicine. It is building the relationship and feeling valued. It begins, grows and thrives by first being personal.
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