A Beginning…

…I shared my reality that the Culture of Healthcare warrants more than one blog. This month I’ve opened the door to what may become one of several blogs I post on the topic or its surrounding subjects. Time will tell as I hear more from You, our readers about what interests You most. Please share your comments!

As February 2022 unfolds we are publishing our blog on the Culture of Healthcare, celebrating:

  • Black History Month (the theme of which is Black Health and Wellness),
  • Ushering in the month of love as we approach Valentine’s Day,
  • The arrival of the Winter Olympic Games.

It proves to be an interesting combination of events all of which reconnects me to the “I Have a Dream” speech. A dream for health and wellness, a reminder to always come from a place of love in our communication with others and the fulfillment of a dream of mine in figure skating for which I’m grateful.

While I won’t be covering the Winter Olympic Games, I will acknowledge the connection between Diversity, Equity & Inclusion and the debut of Jamaica & Saudi Arabia as well as the second time that Haiti & the Philippines will participate in the Olympics this winter season. Asa Miller will represent the Philippines for the second time in the men’s giant slalom event. British-born Benjamin Alexander represents Jamaica in skiing making this the second time Jamaica was represented in the Olympics. Previously Jamaica was represented by its bobsleigh team’s founding member Dudley Stokes.

Debuting will be Haitian born and Italian adopted, Richardson Viano representing Haiti in the men’s giant slalom event. Salman Al-Howaish and Fayik Abdi were both confirmed to represent Saudi Arabia. Although only one will actually participate due to the lack of enough quota points needed for both to take part. This is not an uncommon occurrence that a country may not have enough points for both athletes to compete.

This was the case in the 1998 Winter Olympic Games when the United States did not meet its quota to send three men to compete. Only two men where eligible to compete that year. That placed both 3rd place finisher, Scott Davis and 4th place finisher, Shepherd Clark at the US National Championships in Philadelphia, PA as alternates in the event one or both eligible skaters had to withdraw.

This is a good sign for Diversity, Equity & Inclusion that countries that were not included in the past have found their way into the present by stepping into the Olympic spotlight to be counted among the many countries, seasoned at competition at the Winter Games. This comes at a time when all eyes are on the world of inclusion as we strive to learn how to overcome the challenges that have brought us to focus on the inequities and limitations that have faced the United States since its beginnings and our global community for quite some time.

The need for change is being felt in countless areas of our lives including sport, business and healthcare. Now that the world is seemingly under a microscope to identify more change needed around inclusion and equitable treatment, we are now seeing Diversity & Inclusion becoming an insurance matter. Given the $600 billion in corporate turnover and $10 billion in annual Diversity & Inclusion lawsuits, business leaders in today’s market are charged with finding ways to incentivize inclusivity across industries.

The question is, how do we get ahead of this fast moving snowball so that business leaders can wisely manage the way they do business going forward in this new emerging paradigm shift to legalized inclusion? I encourage you to click the button below and book a strategy session to determine how we might work together to bring harmony to the topic of inclusion in your business.

Multifaceted View

Equity in healthcare is multifaceted. Let’s dive into a few examples.

  1. A person with a comprehensive insurance plan walks into a prestigious hospital in one part of town. A homeless person with no assets or health insurance lands in a hospital in the inner city. They would receive the same treatment in a perfect world, yet we know that is not the case. Equitable treatment means that they both receive the treatment necessary; they hopefully both receive the attention that leads to a cure.
  2. Equity can also involve the doctor listening and understanding their patient. There can be mistrust when the doctor doesn’t speak the same language as their patients or is perceived not to understand the health issues of a specific population.
  3. We can also approach equity in the practice and treatment of those professionals we entrust with our care. We expect them to be there and ready, forgetting they are human beings, and that medicine is not black and white. The cure might not be the same when two people come into the care facility with the same symptoms.

Why is an Equitable Healthcare Culture Important?

Many in today’s healthcare system have equitable treatment as their goal; they are restricted by time, resources, management directives, and insurance restrictions. Nurses and doctors would love to spend more time with each patient, building a plan to cure the ailment that prompted their medical visit and improve their quality of life. Often, they are pressured by the bottom line. Compound this with staff shortages, and it becomes a matter of survival on both ends.

Doctor visits average five to ten minutes, and those in hospitals are often given standard protocols, and they hope for the best. “Come back if that doesn’t work,” they say. This is one example where healthcare is complicated, and, unfortunately, poor choices can be made. Innovations take a while to work their way into the system, and sometimes they are rejected due to cost or time constraints.

The medical profession is designed to treat symptoms and not underlying root causes. Most people aren’t willing to make necessary changes in their lives and look for miracles in pills instead. The challenge with finding a balance is compounded by limits on both ends of the spectrum.

Difficulties Faced by Healthcare Professionals

Medicine is not absolute. Doctors practice medicine in an ever-changing field. This is compounded by no one wanting to empathically accept this reality, particularly when it is a medical issue we face ourselves or concerning our loved ones. We want absolutes that are not always possible.

When doctors look at their schedules, they are allotted very little time with each patient. They are under pressure to get in and diagnose; this usually occurs with little interaction. Symptoms are judged quickly by looking at charts and textbooks. While clinicians may wish to take a deeper dive into a condition, management is concerned with the bottom line and what insurance will financially cover. A headache could mean stress or a brain tumor. Tests rule out possibilities, and they are ordered automatically. Pills are quick fixes. There is little time for exploration. Doctors are expected to be miracle workers.

The underserved (and those who serve them) are faced with even more obstacles. Social justice groups fight for equal treatment; they can only do so much. Each person in the process, from the hospital administrator down to the patient has an active role. First, hospital personnel choose the best treatment regardless of protocols. Then, the patient agrees and engages as a willing and active participant in their own wellness plan. Thus, a shift in economics occurs.

Healthcare is so diverse that it has difficulty adapting. The vast majority of the system works on autopilot.  Participants need to engage on a personal level that complements the science.

Building Trust

For some of us, we have blind trust in the healthcare system. When we get sick, we expect a remedy. When our family members or ourselves are in pain, we want relief. The difficulty lies in each of us working together to be heard. Clinicians and patients benefit when healthcare providers look up from their tablets and listen to their patients. Conversations take time. They require attention, heart, and thoughtful contemplation as information is gathered. This is not a time to give in to the rush we experience today in healthcare.

Unfortunately, many people see and experience those impersonal treatments and avoid doctors and the hospital… until it becomes an emergency. The system is broken and leaves many people behind. 

Others question the science. Hospitals have their protocols, and these are not perfect in every situation. Here’s where politics comes into play. Building a relationship between clinician and patient is the goal. The limits of time negatively impact doing so to a greater degree. This makes it challenging for a patient to share personal information that could make the difference in how their treatment plan is designed and carried out successfully.

Essential Change

There are innovations in healthcare, doctors who buck the system, and patients who bring knowledge to doctors who can set their egos aside to listen to options. This trend is essential to continue, though it is difficult to change a system with long-held yet evolving traditions that seem more bottom-line-focused than patient-focused.

This attitude often starts in residencies. In their efforts to condition future doctors for the pressure, they are pushed hard in training. Sleep deprivation and self-sacrifice are expectations. The fast-paced decision-making process is ingrained. “Working to exhaustion is considered a badge of honor; breaks signify weakness” is how one resident in training boils it down. They are taught this is the norm, so the practice perpetuates.

Consider the impact of management supporting, nurturing, and guiding with a checklist instead of the drill sergeant mindset! Consider the impact of a strong establishment of mentors and coaches instead of senior staff building a reputation for eating their young! Evolving healthcare culture is a difficult task and, while it won’t be accomplished overnight, there are steps that can be taken for the sake of progress.

Tool To Support You

One way to make a difference is to give more time and attention to the tenets of self-care. Abigail, a recently graduated nurse in New York, shared that the lack of self-care among healthcare clinicians is so widespread that it is ironic that these professionals provide our care as patients striving to return to flourishing health and wellness.

First, consider the concept of self-care in a different light. Restorative self-care is attention we give ourselves on a daily, or nearly as often, frequency that is about restoring our mind, body and spirit. This includes our emotional energy and soundness.

As a way of checking your success in seeing to your needs, take a moment to create a list of ways you practice restorative self-care. Give yourself a time limit to create your list by setting a stopwatch for the activity. In the event you choose to brainstorm this list with another person, I recommend two minutes. Should you prefer to create this list yourself, give yourself five minutes to compile the list.

Once you complete your list within the self-allotted time, create four columns on a separate piece of paper with the following headings across the top: Mind, Body, Spirit, Emotional Energy. Then write a sentence or two describing how each restorative self-care action contributes to the topic heading of each column. Then choose someone with whom you feel comfortable discussing your results. Determine by the end of your conversation whether or not you feel you are restoratively self-caring for yourself. The goal is to achieve satisfaction and confidence that you are effectively addressing your restorative health in order to face the pressures of your profession.

You may find it surprising what new insights present themselves to you by the end of this process. Should you discover deficits in accomplishing restorative self-care, click the button below and book a strategy session with me to determine what you can do as a leader to protect yourself from burnout.

Real-World Experience

Consider Amy, a medical student who shares her academic community view. She mentions the grueling schedule affecting her peers, which leads to a lack of healthy hygiene as students scurry from one patient to another, learning on the job skills required to face the general public, often grabbing naps between shifts, and forever in scrubs making it easy to just stay in them for prolonged periods. There are also poor nutrition concerns that plague clinicians during their training and often into their careers, such as not having time to eat a balanced meal and settling for fast food because it is quick.

Doctors face financial concerns once they step into the professional world, including mountainous school debts and liability insurance premiums they carry to protect themselves and their livelihood. This leads to overwork and burnout at a very young age. “We need to not be trying to teach or train physicians and other health care workers to tolerate a broken practice environment,” Dr. Shanafelt said. “We need to actually fix the practice environment.”

Byron is Here to Help

“There are more than 9,000 billing codes for individual procedures and units of care. But there is not a single billing code for patient adherence or improvement, or for helping patients stay well.”
― Clayton M. Christensen

To innovate a healthcare system that serves more people with compassion, clinicians must look up from their clipboards and truly listen. We also want doctors, nurses, and hospitals to break away from standard protocols and over-reliance on the pharmaceutical industry. How we use these efficiently while keeping in mind what is best for a patient, or a medical professional is up to each of us.

Hi, I’m Byron Darden, and I am here to help you navigate difficult paths. Whether you are looking for guidance or a new perspective for your organization, change starts with you, and I can provide the tools to help navigate your leadership within the healthcare culture. Click the button below to schedule time for You and I to explore how we might collaborate.

Diversity in the Medical Profession

We’d be remiss by not discussing diversity in healthcare. While the demographics are changing, the majority of physicians are still Caucasian, and the majority of those who choose to enter the medical field are. Patients in neighborhoods that are predominantly African American and other people of color may feel more comfortable relating to someone in their own community. At the very least, time can be spent on diversity training so that clinicians better understand each patient. Continuous understanding of the medical conditions affecting “minority” patients and learning more effective communication techniques can also bridge this gap—the profession benefits by recruiting and training medical professionals of varied cultures and levels.