I recently drove by a billboard for a health system. It showed a picture of a very happy patient and her very happy doctor, and it read:
"See a doctor who actually sees you."
My thoughts follow, and I'd love to hear yours.
I understand that there are patients who have been let down by our system and by doctors within it.
But I'm talking marketing, and I seriously doubt that the doctors at this one tiny little health system are the shit we've all been missing.
And I get it, from the marketing team's perspective. You've got to set yourself apart. Carve your niche. Why should people come to your hospital?
But.
By picking this as your angle, you're implying that nobody else gives a damn. Those other doctors...you're nothing to them.
You're implying that your doctors are the only ones that care about their patients.
I get bragging about your rankings for cardiac or stroke care, or the level of your trauma unit, or whatever service you provide that's actually unique.
But knowing how many other amazing doctors and other healthcare providers are out there working their asses off to do the best they can for their patients in a system with limited time/resources/control...this hit me.
It hit me at the moment, and it's still here 3 days later.
And even though this was a tiny health system in rural NC of absolutely no consequence to you or me, I just wanted to put this out there.
Be more convenient. Be more specialized. Be more generalized. Be bigger. Be smaller.
But don't act like you're the only ones that care.
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during my MS-3 surgery rotation, i got pulled into a cardiothoracic surgery case. the division, and this attending in particular had...a reputation, and most of us would do anything to get out of working with them. but this time, i couldn't get away.
it was a laparoscopic case involving one lung. my job was to hold the camera--not a particularly difficult job, but one that's really important, and one that's not easy if you've not done it before.
as things were getting set up, the attending was talking to me about how we were going to insert the endotracheal tube further than normal, to intentionally intubate one lung, allowing us to work on the other. brilliant. i'd never thought of that.
when i was in residency, i had an idea for a different practice model. one that would allow me to spend more time with patients, and would let me operate outside the bounds of the typical healthcare system, giving my patients the attention they deserved.
i spent two years working on a business model that i thought would work. i examined similar practices from across the country, took the best parts of them, and implemented them into a practice model that i thought would be great.
but things didn’t go as i had planned. the grand opening was less than grand. i think i saw 2 or 3 patients the first month, which was great for studying for boards, but not so great for paying bills or keeping a practice afloat.
“colic” isn’t a thing. “gripe water” is also not a thing.
except they kind of are. they're multiple things, really.
come with me on this journey. (THREAD)
in 1954, dr. morris wessel published a paper called “paroxysmal fussing in infancy, sometimes called 'colic’” it’s about (as you probably surmised) babies who cry a lot.
the researchers examined the records of 98 babies and separated them into 2 groups: “fussy” and “contented.” how? by using a definition that dr. wessel just made up: babies who cried more at least 3 hours a day, at least 3 days a week, for at least 3 weeks were defined as "fussy"
The story of teething begins, as all good medical stories begin, with Hippocrates, who wrote in the 4th Century BCE that “teething children suffer from itching of the gums, fever, convulsions, diarrhoea, especially when they cut their eye teeth.”
(a thread)
It wasn’t until the late-19th century that a precise mechanism was elucidated. J. W. White explained, “The nervous perturbation occasioned by the eruption of teeth increases the susceptibility and lessens the resistive power of the child.” (There, that sounds science-y enough.)
Just a few hundred years after Hippocrates wrote of the perils of teething, Soranus of Ephesus developed one of the earliest recorded treatments for teething:
1) Kill a bunny (or don’t, but it seems the humane thing to do) 2) Cut out its brain 3) Rub it on your kid’s gums
we shouldn't be here. the management of this pandemic has been a complete disaster from the start. efforts to get this pandemic under control have not been only ignored, but undermined by our president. we shut down for weeks, and we have very little to show for it.
we still lack adequate ppe. we don't have a coherent testing strategy, and the tests we are doing often take a week or more. we still lack hospital beds and icu beds and staffing required to handle what's here or coming. that's what the shutdown was for.
we flattened the curve so that we could address those things, and yet here we still are, months later. people are tired of it, and i get it. i'm really damn tired, too. i want this to be over. but we can't just *decide* it's over, which seems to be what's happening.
In the words of Kenny Rogers, "If you're gonna wear a mask, boy, you gotta learn to wear it right." (Thread intended for HCWs, but important for anyone)
Point #1: If you're wearing a mask, its job is not to protect you. The point of the mask is to protect other people from you.
Because a significant percentage of people infected with SARS-CoV-2 don’t have any symptoms, and those that do are contagious before symptoms develop, we have to assume everyone has it, including ourselves. Your mask is intended to protect others from you in case you're infected.
Masks may provide a slight benefit in protecting the person wearing them, but they are dangerous if not used correctly. It’s helpful to think of things as “clean” and “dirty.” As you breathe--or get breathed on, the mask collects and concentrates viral particles.