Archives For Organization

Using art to heal

June 30, 2015 — Leave a comment

Health factors2Because Health is Life, our lifestyles are just as important to our health as going to the doctor or taking our medicines. In a paper published June 30, 2015 in the Annals of Internal Medicine, a study looking at survey data found that half the heart disease deaths in the US from 2009-2010 were caused by 5 factors all of which can be modified through healthy behavior: smoking, obesity, high cholesterol, diabetes and high blood pressure. But many of these behaviors are difficult to change and are influenced by our families, our culture and our community.

This picture shows that clinical care by doctors and hospitals accounts for only about 20% of health outcomes. The picture comes from a project called County Health Rankings developed by the University of Wisconsin Population Health Institute (and supported by the Robert Wood Johnson Foundation) that looks at health by county in the US. Addressing factors like cigarette smoking, income, education, employment, housing and clear air can help make communities healthier places to live.

We need to find ways to build healthier communities and the arts may be one way to accomplish this.

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Care teamWhen I was in clinical practice as an infectious diseases specialist, most of my patients were very sick and hospitalized but I saw a small number of outpatients as well. They were often people who had nonspecific complaints and were convinced that they had a chronic infection that their doctors were missing. They often arrived with numerous records – laboratory tests results, x-ray reports and consultation letters from other doctors.

While it is certainly possible that these patients had an infectious disease that we don’t know about yet or that I had missed, many of them had significant stress in their lives – housing issues, trouble with their children or spouses, difficulites at work, etc. There is a lot of evidence that stress can lead to serious health issues including heart attacks.

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There is no question that technology can improve the quality of healthcare but it can’t replace the need for good communication.

Dr. Peter Pronovost, a leader in patient safety at Johns Hopkins, wrote a blog post today about how technology can help doctors make the right diagnosis. He cites alarming statistics about how the wrong diagnosis may cause as many as 80,000 deaths each year in the US. He discusses the exciting news that a portable bedside device that is able to measure eye movements, may prove to be useful in emergency rooms to figure out which patients who complain of dizziness are likely to be having a stroke. This development could save lives and also save time and money.

However, in many of the cases of misdiagnosis, the problem is that doctors don’t listen carefully to what patients and their families are saying. They forget that patients are the experts about their own symptoms. Doctors have a tendency to get locked into thinking about a particular diagnosis and may not listen to what patients (and their families) are telling them.

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Comm-inn-orgThe Care Triad doesn’t really work without three important foundations – communication, innovation and organization.

Communication requires that all members of the healthcare team understand that the patient is the most important person on the team. Patients should be spoken to in a respectful way starting with the person who sits at the welcome desk. Doctors need to learn to translate complicated medical information into ways that patients can understand it and patients need to learn to ask questions when they don’t understand what the doctor is saying. Doctors (and other members of the healthcare team), patients and family members also need to learn to talk openly about the end of life. Patients may also find it helpful to communicate with each other in online communities. Both doctors and patients need to learn to use social media to help themselves and each other, recognizing the power of personal experiences.

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