Wednesday, January 4, 2017

When One Door Closes

A Letter to My Doctor
Today I sent the following letter to a doctor.  I hope others are encouraged to share why they leave a practice before they go.


I am requesting that my medical records be forwarded to XXXXXXXXXXXXXXXXX

I will not be able to use your services any longer.  Please allow me to explain why.
First, I should explain how I chose you as a physician — and possibly a surgeon — that I would use.  I put a call out to friends and family for a recommendation.  Your name came up.  Even though our state physician profile lists you as having made five malpractice payments in the past six years, three payments above average, I did recognize that your membership of five prestigious organizations such as the American Medical Association, the Medical Society of State of NY and the Nassau County Medical Society might mean patient safety was important to you. 

I thought it would be important to share with you why I am leaving and can’t recommend your practice.

      1.  I found it offensive and disturbing that my reason for seeing you was discussed at the front desk.  I knew why other patients were there because it is asked when signing in, and written down where the next person can see; also, the receptionist confirmed aloud what my appointment was about.  Although this is not a HIPAA violation it would be a breach of privacy were there someone present from my circle of friends or family with whom I didn’t want to share my business. Imagine if a gynecologist’s receptionist asked whether a patient was there for a pap test or a yeast infection, or to see if she were pregnant.  These discussions belong inside your office.

     2. Although your x-ray technician was very nice, he seemed rushed and impatient with other staff.  He told your PA that he was waiting for me for a half hour.  I was not even there for 10 minutes.  He also did not describe what was happening to me, what he would do, or why he would do it.  He said almost nothing to me.  A brief explanation of what would be happening while he was working – thus taking no extra time — would have been helpful, especially if I were someone feeling scared or alone. It also would have made a great impact on my experience.

     3. I don’t appreciate being called “Doll” after every sentence by a staff person who is half my age (or any staff person).  If she couldn’t remember my name, there are safer ways of confirming she has the correct person.

     4. An unknown, elderly woman in a wheelchair was wheeled into my room while I was waiting for you.  I had to stop the staff person from bringing her in.  He apologized and said he had the wrong room.  This gives the impression that your office is in some disarray and there are on-going problems.

     5. On my first visit with you, you were obviously very sick with a serious head cold and let me know that.  I understand that it is not easy to take off from work, yet you never washed your hands and even after blowing your nose you went back onto the computer in your room without cleaning your hands.  Then, you left the room touching the door knob.
 Dr. XXX, this letter is not being sent as an official complaint to the Office of Professional Medical Conduct, but instead offers an opportunity to review practices that can be viewed as potential hazards to your reputation, your staff, and most importantly your patients. It is very difficult for me to write this letter but I think it is very important that these issues of respect, courtesy and safety are addressed.

Thank you for your time.

Ilene Corina, Patient Safety Advocate

American Medical Association
Medical Society of State of NY
Nassau County Medical Society

Friday, October 14, 2016

Senator Hannon's Senior Health Fair

Table at the Fair

I set up a table at Senator Kemp Hannon’s Senior Health Fair to distribute literature to the people (mostly over 60) who might be interested in patient safety.  PULSE of NY, now called Pulse Center for Patient Safety Education & Advocacy, has had a table there for many years and it has proven to be a wonderful networking event.  We have always been grateful to Senator Hannon for including us in this lively community event.   

For years it was a great opportunity for me to spend time with my parents who have been volunteers for 20 years, then just my mother, and now with them in Florida, it’s a chance to spend time with other Pulse volunteers as we meet the community.

Ideally, I suppose, we are supposed to be making the community aware of our services and how we can help. Instead each year it seems to be a bigger and better event for older folks to go trick or treating.  Just before Halloween the tables are piled with give-aways like pens, back scratchers, hand sanitizers and yes, lots of candy.  Some of the merchants even joke about who has the best candy and we find it fun to swap!

After all these years of setting up tables at fairs, it’s hard to imagine the best way to approach people about patient safety.  Why isn’t the public more interested in becoming an involved patient?  The people on either side of me who worked for an insurance company and another nonprofit each had personal stories of medical care that would fall under patient safety or medical injury.  They got it - but had no plans to share their experience so others could learn from it.  They suffered in silence.  What is the shame?

If we say “medical error” is there automatic blame?  I can assure you that when there is a medical injury, 100% of the time there is a patient involved but yet still patients are left out of the conversation.  That has to change!  Always looking for suggestions how.

Friday, September 9, 2016

Be an Ally

Why is Being an Ally Important?

Why is being an ally important to the LGBT community or any community that needs a voice?

I remember when I did a program at a hospital about sensitivity of working with people who have various disabilities such as using a walker or in a wheelchair.  During the open discussion someone in senior leadership said that they don’t have enough staff to work with people “like that.  “They” take extra time and the rooms are not meant to accommodate their equipment.

If I were in a wheelchair, I’m confident that those words would never have been spoken.  If you think that’s good, I disagree.  They need to be spoken and discussed.  If that VP carried her feelings out of the room and to her staff, it would be a ripple effect and the negative comments and feelings would reach a patient – somewhere.  Now that this is on the table we were able to discuss it, find the appropriate words she can share with her staff (who may feel the same way) and then make accommodations and plan appropriately.  The elephant in the room needs to come out for discussion and to learn what to do.  Keeping this bottled up helps no one.

The same with people who are gay or lesbian or transgender.  A bearded woman may make someone feel uncomfortable but isn’t it her right to grow a beard?  In healthcare it does matter because when toileting or body parts that are different on a male or female.  Should healthcare professionals ask men and women (who are presenting as one or the other) their last menstrual cycle, if they are pregnant or if they have had a prostate exam?  I know of a transgender woman asked her last menstrual cycle in an emergency room and instead of coming “out” she gave a date.

When people have been frustrated over questions and mistakes in pronouns their whole life or people who may seem insensitive to needs, it is the ally who can step up and help with the questions and education.

Yes, I will go to the bathroom with you and gently tell someone to mind their own business if they comment while you get angry.

Yes, I will help you with your wheelchair and ask people to give you room in the hallway. I will help you with your English or help get you an interpreter.  I understand that my friend doesn’t read well and I will help with the consent forms or admission packet.  As an ally, there are many places we can step up and help.  We need to be open to learning from those who want us, what they want from us and then do it.

To those who are living in the world that I don’t know or understand, I ask you to be patient and remember each person you meet does not know the lifetime of struggles you have had.  We make mistakes and may seem inconsiderate because we don’t know.  If you shut us out in your frustration, we will never understand each other.

Tuesday, August 23, 2016

High Cost of EpiPens

Epi Vs Narcan

These past few weeks the high cost of Epinephrine (or EpiPens) has made the news.  It’s not that new.  In March a story came out in ModernHealthcare about the high cost of this life saving drug.  Around the same time I was working with teens who sat at my dining room table and we talked about patient safety and being an Involved and Informed patient.  A young man at 16 years old with nu allergies questioned why Narcan is free to the public and his EpiPen is so expensive. 

We know that many more people will die from drug overdose than allergies but isn’t that the system once again using “measurement” to decide who lives and who dies?  If I had serious allergies and in my financial situation I might be hoping that prayer could work just as well.

Then I realized that if the pharmaceutical companies make a lifesaving medication, people who die from overdosing can come back and buy more medications from the pharmaceutical companies – look who gets rich off this.

What we really need is to encourage Jiff and/or Skippy and/or Peter Pan to go into the business of making EpiPens so those people who are allergic to nuts can eat them.

Saturday, August 20, 2016

John Walsh a National Hero

Why John Walsh is Important to Patient Safety

I admire John Walsh.  You may know him as a television show host finding criminals, The Hunt and years ago he hosted America’s Most Wanted.  Or you may know him as the dad of a murdered child.  He is both.  And, 35 years after his son’s murder he still calls himself the father of a murdered child.  That’s who he is.  No apology.

I met John Walsh years ago when I was a guest on his talk show. (You can see I haven’t changed a bit)  I asked him what makes him an “expert” in what he does.  He is not a police officer, detective, or crime fighter.  He is a dad.  He said he learned everything he could and worked hard letting people know what he knew. 

I admire that in a person.  He believes in something and all these years later he is fighting for what he believes in.

I wish patient safety had a little bit of that support.  Imagine if all the law enforcement would say “Mr. Walsh we don’t need your help we can do this”?  Instead he is welcome as a partner in fighting crime.  Why then is it so difficult for the healthcare professionals and the foundations that help fund their programs to recognize that medical errors and injuries that happen at the bedside need the support of a community willing to help?

I’m not sure I would call myself an expert.  But, through PULSE Center for Patient Safety Education & Advocacy (Formerly PULSE of NY) I do have close to 1,000 hours as a bedside advocate witnessing errors, breakdown in communication and misunderstandings that might cost a patient their life and many, many hours working with people after an injury of death of a loved one.   My volunteering as a board member with TheNational Patient Safety Foundation and The Joint Commission – both for over 10 years each,  I understand how these “mishaps” can be corrected and how, if they are not taken seriously it is similar to playing Russian Roulette with a patient’s life.  Patients and the family who say something and are ignored, rarely have a place to take that information to have the system fixed.

If it is true that medical errors are the third leading cause of death in this country, and there is no reason to doubt this,  everyone needs to get on the same page and work together to not fight crime – but fight the system of errors which is left to only the often overworked medical professionals to deal with on their own.