Medicine has a public relations problem…

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Hello all, sorry for the delay in writing new blog posts, but if your 2016 has gone anything like mine, you’ll understand perfectly. It seems I have spent the last year locked in mortal combat with just about every aspect of my professional life. However, no longer visiting EMS websites and Facebook pages has lowered my blood pressure considerably… Now I can focus on my Polish language skills like I should be.

I have to confess, I really miss living in London, even though the large amount of narcissistic, dishonest, petty gossiping, inbred, monosynaptic fucktards (ask me how I really feel, and don’t worry, I am not expecting or giving and recommendations either. I have discovered in fact their word means nothing anyway) working there nearly gave me a stroke and an ulcer…But I learned a lot from the experience, not least of which is that many doctors do not have 20 years of experience, they have 1 year of experience repeated 20 times. I also learned that despite the GMC requiring an onerous amount of paperwork for “revalidation” many of their senior providers haven’t read a study or updated their practice in the better part of 20 years. The only thing they hate more than actually working is having to face that. But, I have stolen enough of Kelly Grayson’s witty diatribes in this paragraph already, none of my family are at risk of being killed by the UK medical system or its providers anymore, so I look forward to moving on in 2017, or rather I should say…Getting back to the business of obtaining excellence and enlightenment…

What I have to write about is a problem in medicine the world over. I was inspired to write this topic today because as I sit here supposedly doing work I really need to get done, sitting next to me here in Starbucks are some people complaining about their medical care which is not living up to their expectations…

When I lived in London, I used to ride the DLR to work every day, and marveled at all the people I heard talking around me about how the doctors and medical system there was not meeting their needs or wants.

It made me think back to all of the people I heard in the USA who complained about how their medical care and providers were not living up to their needs or wants.

Most of the doctors I associate with, as opposed to those I really hate to even be in the same room with, work their asses off. They have multiple jobs, they come early, they stay late, they make time for every patient seeking their help even when they are over-committed. They are eager to help for the sake of helping, as opposed to how much they can expect to be paid or reimbursed. In many cases, they do not bill, fill out the paperwork to bill, or take money or favor of any kind. Surely these providers (doctors, nurses, medics, etc.) are not the ones driving this disconnect between patients/public and the healthcare system?

I have written before at length on what patients want and why I am fairly certain providers are not meeting them, but today I realized that while it is true that providers and systems are not changing fast enough to meet the needs of patients today, people have no idea what providers are actually doing…I am not speaking of providers who are purposefully doing as little as they can get away with and make money, but the ones actually working their asses off and bending over backwards to move heaven and Earth on a given day.

In a brief summary, as medicine advances/becomes more complex, most providers, and especially doctors, become more and more removed from the communities their patients come from. They cannot relate to their patient populations and therefore cannot anticipate or even understand what exactly it is the patients expect or want.

But more than that, patients no longer understand what providers are doing. When you work in less prestigious jobs than medicine, and as the fire service members are acutely aware, when people do not understand what you do, their perception is that you don’t do anything.

The isolation of medical centers has compounded this problem. With the possible exception of lawyers and some disciplines of science, there are perhaps no equal to those educated in medicine. So while we may not spend our entire days performing feats of physical labor (Sorry my surgical friends and colleagues, there are studies showing surgeons spend <1/3 of their time operating, nobody in the doctor realm is doing that much “physical” work), we are occupying our time doing something (don’t know about you, but to me it feels like paperwork). At least when I was in the fire service, we could be truthfully accused of “eating thanksgiving dinner twice a day while being paid to sit around…”

But long ago, when budgets were being slashed as the public took issue with the “vacation station” lifestyle, the fire service embarked on a massive public relations campaign to demonstrate the value to society provided. By contrast, medicine doesn’t do this at all… Some of the hospitals in the US like to make commercial adverts on why patients should select their given facility to spend money at…I mean seek care from…I have yet to see any medical center, in any country, say “this is what we do every day!”

As an excuse, medicine likes to hide behind confidentiality. They are more worried somebody is going to find out what is going on than they are of showing off what is going on. As such, they give the impression of cover-up even where no cover-up exists. It makes mistakes look like conspiracy and malice rather than the unintentional failings of the good intentioned.

All types of providers are very adept at giving themselves awards, titles, and back patting, but have yet to solicit such from the people they are helping (serving).

Solutions…

We need to hire public relations firms, to make sure our message gets out every day. We need to find a way to foster positive relationships with the media and journalists. We need to go out into the public, out from the protection and confines of the ivory tower in order to be a visible and positive force in the communities we serve. We need to have open houses and develop programs to bring people to the hospitals when they are not sick. Today I was reading a paper published on a blog post about how ineffective trauma prevention programs by hospitals are…It made me realize that it is not our efforts or intentions that are the problem. How can we prevent things in an environment we are not part of or have no insight to? Our prevention programs are not practical, they are theoretical. When we get data they fail, we double down on them…

I am sure some will say that public relations or outreach is not the business of healthcare, but really…Housing the families of sick children is not the business of McDonalds, but nobody can deny the charity or community outreach of Ronald McDonald house. When I was younger, I played little league softball. Our uniforms were provided by the support of local businesses. Certainly none of those businesses were involved in providing free uniforms to little kids…But from that act, I learned an important lesson; a lesson that was reinforced in the fire service. The community supports organizations that support the community. If healthcare agencies are going to thrive, if doctors and other providers want to worry less about being sued, they are going to have to stop building walls and start building bridges with the communities they are serving. It is obvious to me that people did not turn against healthcare providers. Providers turned away from people. It is lawyers and governments forcing providers to listen again, and it is not working…