I had intended to write a different post this week; when I speak to healthcare groups I often use what I have dubbed as my 'airline analogy'. However from where I am seated it just does not feel appropriate. For starters I am at 35,000 feet somewhere over the midwest. That in itself is not unremarkable- I am no stranger to travel. However, this is the first time that I have flown with crutches and an immobilizing leg brace.
The last week was supposed to be our annual ski trip. Let me avoid mincing words by saying that its the week I most look forward to in the year; I work towards the trip all year. Unfortunately this year my professional and personal life were more woven together than I would have cared for.
On the first day our our trip I took a fall that was substantial enough to sever the Anterior Cruciate Ligament (ACL) and damage the meniscus of my left knee in two places. In short, a total blowout. Endorphins and poorly placed ego got me off the mountain under my own power, but the next day things where pretty banged up. My knee was well over twice the size that it should have been and my range of motion was almost zero.
I spent most of Monday in the Steadman-Hawkins Orthopedic Clinic in the Vail Valley
Medical Center. The name Steadman-Hawkins may not be familiar, but the roster of patients would make any sports fan's head swim. The corridor from the elevator to the clinic door (ironically long for a place that specializes in busted joints) is covered with
jerseys, posters, notes and pictures. Chances are that if a pro athlete has suffered an orthopedic injury in the last 10 years, they were probably treated at Steadman-Hawkins.
You are probably asking yourself how an amateur skier got in the door. More on that later.
Every Sunday night there is a group of healthcare and marketing professionals and enthusiasts who use Twitter as a chat-room. Using the 'hashtag' #healthcomm we spend an hour discussing ideas surrounding social media and healthcare. It's fast paced and intense and I always come out thinking about some topic differently. Recently the discussion was about how patients find their care - physicians, hospitals, etc - and what makes a difference.
Many of us who work in hospitals believe strongly in rankings, awards and recognitions. I've written before about the Healthcare Highway in Richmond. Billboards flaunt "Top 100 cardiac care" and "best place to have a baby". But at the end of the day what do those lines really mean? Who said you are a top 100 cardio hospital? Are they objective, are they national and most importantly does a patient really care?
A few facts: in most hospitals, 80% of patients come in through the ER. Those that have non-urgent surgery or deliver babies are usually directed to a hospital by their physician. In other words, most patients do not pick their hospital. When it comes to physicians the story is pretty similar. People are influenced by word of mouth for their primary physician but how do people find a specialist? According to the American College of Surgeons more than one-third of Americans do no research at all. Those who do research their surgeon spend less than one hour doing so (compared to four hours planning a vacation).
I consider myself fortunate and not just in the sense that I will make a full recovery. Though personal and professional connections I was able to get a same-day appointment at Steadman-Hawkins. Most people would go to the ER and while I am confident that they would still receive excellent care, I am doubtful that it would have been as personal as my visit was. After the consult I had a choice: surgery with a world-renound physician or travel home where I could recuperate in more comfortable surroundings. There is a lot to be said for having surgery at home, from followup care to sleeping in your own bed. The challenge was finding an orthopedic surgeon in Richmond that I would have the same level of confidence in. This is where working for a health system has its advantages. Not only am in the less than one-third who does research their care, I have the professional skill set to wade through the nonsense and the acquired confidence to push through the red tape. I know the difference between an orthopedic fellowship in one place and a residency at another. I have no problem insisting to speak to doctor's nurse rather than waiting for a call-back that may never come. And when push comes to shove, I know first hand the financial ramifications for me, the physician and insurance. At the end of the day, what made the difference was speaking to a doctor in Richmond. This particular surgeon, either through coaching or personal gift, made a real and genuine connection. Here was someone that I knew could care for me and who had made a point to care about me. That is a winner every time.
There is no profound take-away here, just a recognition of a few things. Saying that you are number one may not mean as much as we think. There is no doubt that it strengthens employee engagement, and that is a great thing. But for most patients, the billboards have very little impact. I have discussed on this site the relevance of The Cluetrain Manifesto. That work suggests that a personal connection goes further than anything else in impacting markets. Furthermore, as social networks level the playing field across the powder-distance index, it makes it eve easier for patients to build that relationship. Post a comment on a forums about a bad physician and there will be an impact, even if the doc is unaware. Say something great and patients will beat a path to their door (look at Steadman-Hawkins). When the physicians take the time to reenforce those positive statements by making a personal connections it will always be a success. Providers need to participate in that relationship by making sure the image they cultivate is one that makes sense to patients and employees, not just industry insiders.
As patients, we have to realize that the power is already in our hands. The ACS suggests that If you were going to spend $1,000 on vacation you would take the time to make an informed decision. Shouldn't we do at least that much when it comes to our health? Being cared for and about has two components- clinical quality and real human caring. If you cannot get the information or response, demand it. Not sure what the federal quality measures on the hospital's site means? Ask until you get an answer you are satisfied with. If you sense physician or the hospital does not care about you personally, go some place else. What does it say about a doctor who discourages patients from discussing their care? Do your homework and make sure you are being cared for and cared about.