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Continuity leads to relationship, trust and better care

Posted May 18 2011 4:38pm

by Thomas Dahlborg

I went to the gym the other day to work off some stress. As I prepped for my big workout, I saw one of my son's former coaches (let's call him Jim). This individual is a great coach and leader, and someone who is clearly in very good shape.

"Hey, how are you?" Jim asked me with little enthusiasm and energy. Being the smooth talker, I of course responded with, "I'm good. How are you?"

Have you ever asked a seemingly innocuous question only to find it was not so innocuous?

"I'm not doing very well. I was told I had had a heart attack."

Jim proceeded to say that he had recently gone to a new doctor for a routine EKG (are they ever really routine?) and upon completion, the doctor said callously: "So, when did you have your heart attack?"

Jim at first thought this doctor was joking. (Yes, I know ... a sick joke indeed.) Jim responded that he did not have a heart attack (or at least never thought he did) and didn't know what the doctor was talking about.

But the doctor stated matter-of-factly that based on the test results Jim clearly had a heart attack in the past and he needed to follow up with his personal physician right away.

Jim was in absolute shock and followed the doctor's orders. He called his personal doctor's office and set up an appointment to discuss his previous heart attack.

Jim shared with me that from the time he heard the news about his heart attack until the time of his follow-up appointment with his personal physician he experienced chest pain, pain in his jaw, arm numbness, etc. And each time he thought, "is this another heart attack ... am I going to die?"

Finally, Jim saw his personal doctor, who spent a great deal of time doing an appropriate assessment, reviewing the notes and test outcomes associated with the EKG and previous exam, as well as talking and listening to Jim. He then said: "Jim, you did not have a heart attack. The other physician had misinterpreted the results. You are fine. Don't worry. See this and this and this ... you are fine. No need to be worried."

Although Jim's physician shared a lot more information, once he heard "no heart attack" he was so elated much after that was a blur.

Jim said he was truly "thrown for a loop" with the original declaration that he definitely had had a heart attack, and the emotional rollercoaster he and his young family experienced really impacted them all.

In the end, Jim realized how grateful he is for HIS physician--the physician with whom he has a trusting relationship, the physician who truly knows and understands him, the physician who shared empathy and time and wisdom with Jim, and who (of course) provided such GREAT news!

It still amazes me how important time, relationship, caring, continuity, trust and empathy are to healing AND how consistently the healthcare "system" considers these items as afterthoughts and/or positions them as unimportant, or worse, sets them aside to ensure productivity and revenue generation.

At least half of all medicine lacks scientific validity, according to the Institute of Medicine. Much of all clinical research is wrong, according the work of Dr. John Ioannidis and his team. Bias and conflicts of interest run rampant in mainstream medicine and lead to patients being placed in danger (See Medical societies are financially tied to drugmakers and Overtreated by Shannon Brownlee). And yet the tried and true healing powers of time, relationship, caring, continuity, trust and empathy are pushed aside and indeed mocked in certain industry circles.

This is just one example that fortunately had a positive ending. How many are out there that do not?

Thomas H. Dahlborg, M.S.M., is executive director of the physician practice True North Health Center , where he focuses on improving growth while ensuring access for the uninsured and the elderly. He has 21 years of experience creating competitive advantages, analyzing customer expectations, and developing and implementing focused and aligned strategic deployment plans. Formerly he served as the chief business strategy officer at Network Health, a comprehensive Medicaid health plan based in Cambridge, Mass.; and was COO of the U.S. Family Health Plan at Martin's Point Health Care in Portland, Maine.

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