Friday, May 04, 2012

On Sherpas, Dams, and Mutant Porcupines: The Art of Keeping Patients First in a World of Diminishing Returns

This is a guest post from my amazing hubby, Ben.  I read the 'speech' that he gave for his graduating students at Georgia Tech today and wanted to give you all a chance to see who I get to live with every day.  I'm pretty proud.  Hope you enjoy!  

I was asked by Chris just a couple days ago to say a few words goodbye, and so I said yes thinking it would  be just that…a few words goodbye.  Three hours later, I received an email asking for the title of my presentation – which caught me a bit off-guard, but I wanted something that would be memorable to all of you and felt that I needed to reference some themes from my time teaching you.  I also felt that I should talk about something serious in nature as well, so…

As you are set to embark on this next phase of your journey, the role of being a resident, let me just bestow upon you some words of wisdom.  I will stray from the typical cliché remarks that you hear at graduations; such as “You will NEVER make any money doing this”, “Now it is time for you to get a REAL job”, and most importantly, “Today is the first day of the rest of your lives” and will try to focus on a topic that you will deal with fairly soon. 

Somewhere in the next few months, you will run into a situation where you are faced between making a business decision and a humane decision – a place where doing something wouldn’t make financial sense, but which could potentially benefit a patient – a person that is in need.   There is a struggle there,  because everything cannot be given out for free, otherwise you would not be able to help others when the money runs out.  But at the same time you got into this field first and foremost to help and serve others.   So what do you do, especially as a resident?  While I cannot give you the answer, I can impart on you how I think and what I have been taught when it comes to patient care.

Someone very influential in my career once told me to treat every patient as if that patient was my daughter, spouse, or parent – basically to empathize with patients as people with needs that are to be met, needs that could easily be for your loved ones.  Put yourself in their seat and try to understand how it may feel to be given, and sometimes treated, as just a diagnosis.  That is how I try every day to practice – treating patients as individuals with the respect and compassion that I would show anyone that I love and expect to be shown towards those that I love when they are in need.  Treat patients as people with hopes and dreams just like me.  You do not always get back the appreciation directly from the patient that you might expect, but it only takes a few to make practicing worthwhile – those patients that take the time to engage back with you and let you know that you have had an impact in their lives.  Those are the patients that you do not want to forget.

In practice, I have personally committed myself to provide the service that I deem necessary, choosing designs and products that will potentially enhance the outcome for the patient.  There are many times where I feel it would have made more sense to give the patient $25 and gas money to the nearest competitor than to provide a service to them, but even though that may be true, that never will happen.  In business that is called a loss leader, a product that is sold at or below cost to stimulate other, more profitable sales.   In healthcare, the art of patient care involves sometimes taking care of patients first and profit second, with the hope that by doing the former the latter will follow.  This is because how you care for your patients spreads and your patients become your best advocate to referral sources and other potential patients if you treat them well. 

Personally, some of the items and projects that have provided the most satisfaction to me as a practitioner have been the ones that have brought little to no income to the company.  From making floor-reaction AFOs for an American Girl doll to match the AFOs of the little girl who was trying to cope with having spina bifida, to making a custom abdominal binder with a bottle carrier for the child so there was one less item to be carried around the hospital, and to the little girl with CP who needed only a shoe lift that wouldn’t have been paid by insurance and referring them to a cobbler who could do it for a fraction of the cost that I could have provided.  All of these instances gave me an opportunity to impact someone in a small way.  Sometimes these are ways that may seem extremely small to you, but may have a huge impact on the outlook of the patient and their family – giving them the feeling that someone has taken the time to show compassion and care in a world that can sometimes feel very impersonal.  The AFOs, abdominal binder and shoe lift will never “cure” those children of the disabilities that they have, but they did make a difference, even if for a moment.   Just as a mutant porcupine beavertail provided a little bit of relief during a grueling day of lecture on scoliosis, small things that are unplanned can become the most memorable.

So as you leave these hallowed grounds where we could debate endlessly about exactly how you measure 90 degrees, where is the lateral epicondyle, and just exactly what would a fish say when it hits a wall... remember why you are in this field to begin with – for all of you I can guarantee at least some of the reason is because you want to help people.  That ever-present feeling that you want to do something that you know can, and will, directly impact another human being.

I also, before you leave, want to thank you all for being such a great class to teach.  As my first real class, it has been a pleasure to learn what works and what does not work and feel appreciative that you have all been so patient during the process.  I will always remember each of you for the impact you have had on my career here at Georgia Tech and now have the pleasure of referring to you as colleagues, instead of students – that is of course except for Kaitlin and Liz, who shall now be known for their Sherpa-like qualities over the next year at CHOA. 

Thank you and good luck!

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