Why is an Equitable Healthcare Culture Important?

Posted on by Byron Darden

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

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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

Posted on by Byron Darden

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

Posted on by Byron Darden

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

Posted on by Byron Darden

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.

Strategy Session

Real-World Experience

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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

Posted on by Byron Darden

“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.

Let’s Collaborate!

Diversity in the Medical Profession

Posted on by Byron Darden

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.

Founder’s Corner

Founder’s Corner

Posted on by Byron Darden

During this, the celebratory birthday month of civil rights leader, Dr Martin Luther King Jr., we are reminded of his commitment to a dream for us all to one day find equality among our brothers and sisters along with achieving equity in moving ahead in our lives. That dream continues to light the way most significantly in these turbulent times of an ever evolving pandemic, focused attention on Black Lives Matter and a microscope on Diversity, Equity and inclusion in all its many forms.

One of which is the desperate existence of our healthcare workers who are stretched to the limit with seemingly no end in sight. As nations across the globe continue to grapple with how to cope with staff shortages, overwork and the growing fear of yet another variant showing up, tensions are high. This condition is sending us back into isolation, triggering more social limitations and prompting finger pointing that is causing nerves to fray at alarming proportions.

The culture of healthcare is a huge topic! I cannot do it justice in one blog. I can provide a glimpse into its challenging environment to provide a starting place from which to begin addressing all that healthcare encompasses while it seeks to find solutions to problems that reveal themselves as fast as the infection spreads.

I’ve spent most of my life surrounded by the world of medicine. Family members, friends, colleagues and clients come from various aspects of the medical field from doctors to administrators and from hospitals to insurance companies. Yet with all of my experience healthcare continues to be a daunting world in which to affect change. It is happening and yet, while the pace of change may seem slow, by contrast the world of medicine changes at warp speed with innovations and technology. It is the human side of healthcare that suggests stagnation.

What I find particularly disturbing is that no matter with whom I have a conversation, the underlying issues that continually surface. It can be summed up in a recent conversation I had with one clinician who spoke of the extreme outrage between administrators and clinicians over COVID–19. According to numerous caregivers, administrators asked/expected clinicians to put their lives on the line by not wearing masks from the very beginning, citing improper Personal Protective Equipment (PPE). When asked what all was included, I was given a list encompassing, along with face masks, face shields, gowns, gloves, other protective measures, etc.

Another clinician shared that the policy not to wear masks changed when many clinicians began getting sick themselves, some dying while others elected not to continue working. Additionally, conditions got so challenging that across the country here in the US, medical students are being turned into doctors early to support and offset the staff shortages that ensued.

One occupational therapist who had gone into semi-retired in 2019, found herself unable to get much in the way of part-time work after the arrival of COVID–19 due in part to her refusal to take the vaccine. While some share their outrage, it is worthy to note that such avoidance to the vaccine have not always been based in sheer resistance or the stoking of conspiracy theory notions. Instead it is the understanding that taking the vaccine could actually kill some due to the vaccine reportedly triggering blood clots identified as a side effect that cause some underlying health conditions to become fatal.

We are at a pivotal moment with our healthcare that suggests the dam most assuredly will break sending flood waters spreading as fast as the wildfires in California and as rapid as the rising number of COVID-19 cases with more variants becoming known.

Given what is being discovered about COVID-19 as time passes, it seems the relationship between administration and clinicians – identified as somewhat adversarial – has remained relatively the same these many months. In a less than satisfactory attempt, some hospitals have even tried to demonstrate their appreciation by sending care packages to clinicians with self-care tips, inspirational quotes and an array of items that simply miss the mark. This is not unlike the state of affairs that triggered the ‘we’ve had enough’ exasperation that lead to the civil rights movement. What might Dr. Martin Luther King Jr. say to us now about our current state of health affairs as it relates to equity?

What this boils down to is that being humane isn’t just how healthcare facilities should be to patients, healthcare must be humane to its employees as well. It seems the lesson is far from learned and it will take something more significant before we see such humane behavior truly rising to the surface as an imperative.

Stephen Knight is an RN in the Step Down Unit (SDU) of a hospital in New York City where an intermediate level of care between the Intensive Care Units (ICUs) and the general medical-surgical wards is administered.

It was one of the first units in the city to become an exclusive unit during the first wave of COVID-19. At that time the number of deaths rose from one every couple of months to multiple deaths per day. That was the case throughout the city as clinicians faced not having what they needed to keep patients alive. That became an overwhelming experience.

The public remains divided on just how real an epidemic we face. We have such varying opinions among us on how to respond to the epidemic, that once again a growing number of people are falling ill as new variants arise.

The lingering impact of COVID–19 is effecting us to such a degree, that many are growing weary and tired triggering a less vigilant effort around safety and prevention. In addition, healthcare workers are challenged with effectively managing triage. Essentially new cases are competing with non- COVID–19 cases creating a greater challenge for our healthcare system that is already strained.

The danger to society is that hospitals become overwhelmed by cases that could be avoided. As such, exhausted healthcare workers are electing to leave the profession altogether or in some cases, choosing to travel to other hospitals for better pay.

 “Sometimes I want to scream from the rooftops of building. Please take this virus seriously”, Says Stephen. The travesties he has witnessed have taken their toll on him and his colleagues; fellow nurses, doctors and other clinicians who say “keeping up with the demand feels hopeless at times. You just keep on moving and trust you can save more lives tomorrow. Or at least make patients more comfortable than they were last.”

“Everybody needs to care for themselves and each other and let us have time to care for ourselves”, says Knight. When asked what he most wants at this juncture of the pandemic, the over worked Mr. Knight shares, “What I want most is for people to recognize and take responsibility for their role in staying healthy because I need a break and I can’t get one.”

What I am hearing and seeing is that clinicians are finding themselves returning to what seems like the front lines of the most horrific of wars, the war against ignorance.

Measuring Leadership

Posted on by Byron Darden

Some say leaders are born, and some say they are made.  I would assert that some of both are necessary to create a successful leader.  A central aspect of all successful cultures is its leadership. This is where the context gets set and played out in how the organization functions.

“Leadership is intangible, hard to measure, and difficult to describe. Its quality

would seem to stem from many factors. But certainly, they must include a measure

of inherent ability to control and direct, self-confidence based on expert knowledge,

initiative, loyalty, pride, and sense of responsibility. Inherent ability cannot be

instilled, but that which is latent or dormant can be developed. Other ingredients can

be acquired. They are not easily learned. But leaders can be and are made.”

General C. B. Cates,

19th Commandant of the Marine Corps

We are certainly in a time where the General’s perspective is more important than ever and to a greater degree. Given the intangibility of leadership and the difficulty in measuring and describing it, leaders post pandemic outbreak will need to sharpen their skills and heighten their awareness of how to be agile and adaptable to meet the ever-shifting landscape of leading teams effectively. This is where we can help you solve The People Puzzle™, deeply rooted in developing skills that take your leadership performance to a stratospherically level, can make a difference in shoring up the culture in your organization. Click on the button below and book a strategy session to explore how we can support you in getting the tools you need to lead in this new and emerging paradigm.

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