The Way to a Provider's Heart is ... (Through the Stomach)

This topic was inspired by a gal who has become a follower of Lumigrate in the past few months and who, it turn out, is now hopefully contributing a great idea which you can read about.  She has fibromyalgia (and kids and a husband and extended family) and she was commenting on how fortunate she feels to have a physician who is really able to help her, and he will even listen to her whine a little bit when she needs to.  Having been a provider for many years, I know the 'business side' of things, so I was picturing the clinics I've been part of where the patients go home at 6 pm and we're still there trying to get out the door but also do paperwork while having some serious low blood sugar and a 'snack attack'.  And thristy --- it sound unbelievable but there are some days you really don't have time to drink enough fluids.  I suggested she might take the doctor's office some goodies and she said she had been doing that for years.   

Therapists are in a really interesting position, as are nurses and other ancilliary providers, because we are considered non-exempt from overtime as someone would be who had responsibilities such as a salaried or management position, so if our schedules get blown somehow we have to either have management that will support overtime and allow us to complete our work/paperwork or make a decision about how make the situation work.  And we're working with people, we're not making widgets.... People are late and they have something going on that just does not 'fit' into the designated appointment time.  On average you should be able to have things work out just right but some days you have a lot of cancellations and no shows (and your "productivity" then is bad, which is not good).  Other days are better than perfect and you can bill for 80-100% of your time as your company requires but since you can't charge for doing your paperwork unless you are in the presence of the patient you have to either give up your lunch break or take up your patient's treatment time while you do your documentation.  I always thought that made sense to do it with tme there, but they became restricted by thinking that you were writing things down about them so it didn't really seem that was the best thing to do for the patient.   Doctors I know are frequently talking about the documentation burden of their job, and as a person with a chronic illness, I can appreciate how much paperwork they and their staff are doing for all the tests, preauthorizations, billing, etc. on top of that.

Believe it or not, I didn't use a computer at work in the medical field until 2004!  Every day I would have to write the same thing about the same patient pretty much with a pen when I can type about twice as fast and then you can block and paste and all that too. I literally had forgotten how to compose with pen and paper when I returned to college in 1994, as I composed on a keyboard starting in 1983 at work in the natural sciences field and bought one of those IBM PCs with the two big floppy disks for home in 1985 I think.  It really felt at work every day like I was going back to Stonehenge or something and I should be getting out my chisel and mallet!  And in the past five years when I was working where they used computers, the software was unbelieavably time consuming (unless in one case they wrote the software themselves -- that actually was impressive).  And in the medical world the profit margins are so very shaved down anymore they simply cannot afford that learning curve.  So hopefully that will help shed some light for some of you on what might be causing some of the issues you are experiencing with medical practices.

My recommendation is that medical consumers take the opportunity to just read this quickly and realize that systems take a long time to change.  There is something called 'systems theory' which is very intersesting to study whether you are a person coming into or leaving a family or there is a huge company or government change going on.  An analogy I like is to think of a system as a big mobile (like is above a baby's crib) and when you take or add a figure the whole thing jiggles and then has to rebalance and you really can only add or take away a small amount at any one time or the whole thing will fall apart.  So realistically, change in health care is going to have to be a very long process of continual evolution.  Right now there is a huge movement to move to electronic medical records and that will happen if it hasn't already for you, but it is going to take a while for everyone to have that and for all of us to be able to access it. 

In Grand Junction, an exemplary place in the country related to the medical world, the medical community has had electronic records for almost five years but it does not include the consumer having access to the system.  In my opinion that is leaving out the most important person in the medical team -- the patient.  YOU!  (See the home page of Lumigrate.com if you haven't already.)  So it's just as important now for people to ask for copies of their data to be sent to them when checking in for procedures or having an important conversation with their physician -- you can't have the information you need to look things up in the future or have it to share with other providers you visit if they need it unless you ask typically. 

And if you feel inclined to thank your health care provider with a card in the mail, that is great -- most clinics I've worked at have an area where other patients don't have access and those things can be displayed for staff. But if you take the time to make something or even drop off some liquid refreshments, it can provide a much needed boost in morale as well as blood sugar!  I used to have patient's families ask me if they were allowed to give me a gift and I would tell them that we really couldn't accept because people who weren't able to do so were at a disadvantage but what I came to realize was they were going to bring you something whether it was okay or not, so I'd suggest they bring something that could be shared with the staff.    A few years ago I had a young man as a patient who was recovering from a head and spinal cord injury he sustained at work and his biggest concern when I met him a couple of months later was he couldn't remember how to cook and he had loved cooking.  I took him in the kitchen at the clinic and showed him how to melt chocolate chips in the microwave and dip pretzels and graham crackers for snacks for the staff later that day and he realized he could learn how to cook something he'd never made before, he could learn again to cook things he once did.  Before I knew it, he came in one day with some stuffed shells, and I recall eating them at the end of the day at my desk, ever so grateful for his thoughtfullness.

In Grand Junction right now the peaches are fully in harvest and I've heard people saying they have bought some for $5 a box --  I truly appreciate the people who answer the phones and push the paper around, because the whole office acts as a team to support the provider whose services you are paying for.   Fruit is an excellent choice, and if you want the best of both worlds, chocolate dipped dried fruit (and then some without the chocolate for those rare staff members who do not like chocolate).  And fruit is gluten free for those who have celiac! Popcorn is a big hit typically (already popped, not microwaveable as rules sometimes prevent that due to people in proximity who cannot eat) and bringing it at unique time of year kind of rounds things out and you'll stand out a lot more.  Nuts obviously are good as long as they are allowed because of nut allergy sensitivities for some reason.  Flowers (though those are sometimes not okay because of someone having inhalant allergies).  Or if they have a coffee pot, some special coffee or teas.  Believe it or not, I once worked in a clinic that didn't have a coffee pot.  Every place is different yet they are the same, just like people in a way.  So maybe THAT is the hardest part, is just giving out what your providers will eat. 

The gal who inspired me today to write about this has become much more conscious about nutrition in the last year and her long-standing "appreciation foods" she gives have shifted with her personal habits as well.  "But I throw a few goodies in there too!"  Nice!  Any suggestions, please email us here at the website! 

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Comments

Fri, 08/28/2009 - 8:57pm

#1 [2]

Alice F.

Title: LumiGRATE Poster - Minimal

Joined: Aug 28 2009

Posts: 1

Re: The Way to a Provider's Heart is ... (Through the ...

Good article.  Yesterday I was amazed at the amount of paperwork required before I had surgery.  The nurses just kept thanking me for having all my information organized and printed for them.  Never have I had better treatment.  I tried to remember all the names as they introduced themselves and call them by name as I talked to them.  They appreciated that I was interested in hearing their stories instead of burdening them with mine.  I have to go back to the surgeon's office next week and was considering taking them hot biscuts and fig preserves.  If I am not up to that I can always go by Sam's and pick up an 8 lb. bag of apples.  Thanks for the enlightenment.

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