Improving health care with the simple act of listening

first_img About the Author Reprints First OpinionImproving health care with the simple act of listening Privacy Policy Please enter a valid email address. [email protected] Dr. Olveen Carrasquillo conducts a checkup at the University of Miami Miller School of Medicine. Joe Raedle/Getty Images The idea that more is better has many Americans going from doctor to doctor to doctor, getting test after test, and becoming increasingly anxious about our health while increasing the cost of health care.We’ve been told that a big problem with health care is inefficiency and waste. (It is.) We’ve been told that old fashioned doctoring results in huge variations of care. (It does.) We’ve been told that constant electronic nudging will make doctors better. (Maybe.) Doctors are being told they must make their productivity numbers to keep their jobs and prove they are efficient. (Sad but true.)Pioneering cardiologist and Nobel Peace Prize winner Dr. Bernard Lown has said that the usual rules of efficiency are inverted in medicine. The more time a physician spends with patients, the more efficient he or she becomes. Listening costs next to nothing, and so is infinitely more cost-effective than drugs and devices. Listening promotes healing and causes no harm. In fact, it’s the bedrock of a genuine trusting relationship — something everyone wants from their doctors and nurses. In the tone of voice, in the subtlety of the pattern of pain, in getting the sequence of events right — that’s how a correct diagnosis is made and the person emerges from the patient. If all health care providers listened better, we would save billions of dollars and transform the system. So why don’t we have the time we need to listen?Because clinicians have been put on a treadmill driven by the pitiless demands of a false concept of efficiency. Money has replaced quality care as the measure of health care. The idolatry of the market is driving a race among hospitals, insurers, and manufacturers to get bigger and bigger.To fix health care, we need a genuine democratic dialog. To start that, our society needs a massive dose of listening to understand what really matters to patients and communities.This week, close to a thousand doctors, nurses, and patient activists are making extra efforts to highlight the lost art of listening as part of Right Care Action Week, which is sponsored by the organization I run, the Lown Institute. In order to listen to Americans talk about their own health and the health care they receive, they will set up listening booths on busy streets, participate in health care “story slams,” and call patients to ask what worries them most. Tags health carelisteningRight Care Action Week @DrVikasSaini She’s calling for a health care revolution. The radical first step: listen to patients Leave this field empty if you’re human: If listening matters in the exam room, it matters even more in our society.In the early 1960s, a decade into the civil rights movement, students went to Mississippi to organize partly because it was the most difficult place in which they could imagine being successful. When they arrived, they met with scores of leaders in the churches and NAACP chapters. They solicited ideas from ordinary local people like sharecroppers and farm laborers. It was through this months-long process of intensive listening that the students learned what people wanted from the civil rights movement: “What we want is to be able to vote.” The next phase of the movement was born, and together they made history.We face a similar moment today in our efforts to fix health care. To make a difference, we must first identify what matters most to patients, health care providers, and communities. To do this, we must all learn to ask open-minded questions and listen carefully. That’s why doctors, nurses, students, patients, and community leaders are listening hard across the country this week. It’s the necessary prelude to action.Vikas Saini, MD, is a cardiologist and president of the Lown Institute in Brookline, Mass., which sponsors Right Care Action Week. Related: By Vikas Saini Oct. 17, 2016 Reprints Vikas Saini In medical school, doctors-in-training are taught that 85 percent of a diagnosis comes from a careful history, and another small portion comes from the physical exam. But these days we are so busy testing that it’s easy to miss the subtle — and sometimes not so subtle — indicators of a patient’s health. It’s certainly quicker to order the test, get some numbers, and then treat the numbers instead of the patient.The doctor-patient visit is becoming a commodified transaction rather than a collaboration. Clinical life feels more and more like sprinting on a hamster wheel, chasing unproven metrics to get graded on “quality.” It’s no wonder that burnout is exploding among physicians across the country.advertisement Newsletters Sign up for First Opinion A weekly digest of our opinion column, with insight from industry experts. Ten years ago, a woman with a heart murmur who experienced a bout of dizziness saw me for a second opinion. Another cardiologist had told her she needed open heart surgery to replace a valve in her heart. The idea of surgery terrified her, in part because she believed she would lose her job if she took time off from work. She knew she needed a new valve at some point, but hoped to put it off until she retired in eight years.Her cardiac ultrasound looked horrible and, based on that alone, qualified her for surgery. But the more I listened to her story, the more it didn’t add up. Her dizziness had been fleeting, likely from a virus. She was extremely active, exercising vigorously several times a week with absolutely no symptoms. Her pulse wasn’t worrisome, nor was sound of her heart murmur through the stethoscope. I asked her to do a treadmill exercise test, which she passed with flying colors.So I ignored the ultrasound results and listened to what my patient and her body were telling me. When I said it would be perfectly reasonable for her to wait on surgery and check in with me every six months, she overwhelmed me with her gratitude and relief, like I had commuted a death sentence. This year, 10 years later, she finally had her valve replaced.advertisementlast_img read more

Report Shoddy Goods to CAC

first_imgRelatedReport Shoddy Goods to CAC FacebookTwitterWhatsAppEmail The Consumer Affairs Commission (CAC) is urging Jamaicans to lodge all complaints of shoddy goods and services with the agency.CAC Regional Officer, Timothy Watson, said that aggrieved customers often try to seek redress on their own, which may lead to violent incidents.“We want the consumers to know that the Consumer Affairs Commission can provide them with adequate help, so they need not take matters into their own hands. All they need to do is call us. We are here to maintain fair play between the consumer and service providers,” he stated.Mr. Watson was addressing the quarterly meeting of the Manchester Parish Development Committee held recently at the Ridgemount United Church in Mandeville.He assured that the CAC responds quickly to consumers, who feel that their rights have been violated.“In a market economy, the market doesn’t assure you of safe food and products, so we have to ensure that as a Commission, we provide ample service and protection to the consumers against elements, who might want to take advantage against them,” he said.He informed that last year the CAC secured some $23 million on behalf of aggrieved customers. More than $2,000 complaints were lodged with the agency, with more than 90 per cent resolved. RelatedReport Shoddy Goods to CAC Advertisementscenter_img Report Shoddy Goods to CAC Office of the Prime MinisterAugust 3, 2010 RelatedReport Shoddy Goods to CAClast_img read more

Customer Service Improvements at PICA Pay Off

first_imgRelatedCanaan Heights Poised To Become A Model Community Story HighlightsThe Passport Immigration and Citizenship Agency (PICA) is reaping rewards from improvements made to its service delivery processes.Customer Service Director at PICA, Lesline Chisholm, told JIS News that during the period 2012 to 2014, PICA implemented technological solutions, and provided facilities and services for customers with special needs.Focus was also placed on improving efficiency through staff motivation, while strategic alliances and stakeholder partnerships were formed in an effort to offer extended and varied services to customers. Customer Service Improvements at PICA Pay Off National SecurityOctober 5, 2015Written by: Shelly-Ann Irving Customer Service Improvements at PICA Pay OffJIS News | Presented by: PausePlay% buffered00:0000:00UnmuteMuteDisable captionsEnable captionsSettingsCaptionsDisabledQualityundefinedSpeedNormalCaptionsGo back to previous menuQualityGo back to previous menuSpeedGo back to previous menu0.5×0.75×Normal1.25×1.5×1.75×2×Exit fullscreenEnter fullscreenPlay RelatedPM Says Jamaica/UK Partnership Vital to Economic Programme FacebookTwitterWhatsAppEmail center_img RelatedLyme Bay Crew Rehabilitate Halfway House in Clarendon Photo: Donald DelahayeCustomer Service Director at the Passport Immigration and Citizenship Agency (PICA), Lesline Chisholm. The Passport Immigration and Citizenship Agency (PICA) is reaping rewards from improvements made to its service delivery processes.Customer Service Director at PICA, Lesline Chisholm, told JIS News that during the period 2012 to 2014, PICA implemented technological solutions, and provided facilities and services for customers with special needs.Focus was also placed on improving efficiency through staff motivation, while strategic alliances and stakeholder partnerships were formed in an effort to offer extended and varied services to customers.These initiatives have paid off with PICA being among six entities shortlisted for awards in the Public Sector Customer Service Competition (PSCSC).PICA has been nominated in the categories of Most Improved Customer Service; Most Socially Aware; and Most Creative/ Innovative customer service entity.“We are grateful that we have been shortlisted for three categories of the competition and our customers are pleased with the improvements we have made,” Ms. Chisholm said.She told JIS News that over the two-year period, PICA also increased its passport and mobile unit access points.“Our customers benefit from the convenience of having the services brought directly to them. There has been a 64 per cent increase in the number of passport mobiles conducted in communities and offices over the period. Even our customers in London, Birmingham and Manchester (England), have benefitted from the roving passport service,” she informed.In addition, PICA upgraded its website, with an online tracking facility for passport applications added.“The upgrade resulted in an automatic improvement in the quality of service to customers locally and globally. Since the website upgrade, page views (hits) grew by 72 per cent from 478,000 views to 824,000,” Ms. Chisholm boasted.In addition, the queueing system has been improved to better serve people with special needs, while the Advanced Passenger Information System (APIS) has been upgraded to expedite airport passenger processing.“(This) has resulted in 80 per cent of passengers breezing through the airports onto their destination,” Ms. Chisholm noted.She told JIS News that at least 200 more passengers are processed hourly at the Norman Manley International Airport in Kingston, and 400 more at the Donald Sangster International Airport in Montego Bay.“The introduction of the kiosks has caused a 50 per cent reduction in the personnel required to man immigration booths at both airports, as approximately 18 per cent of passengers currently use the kiosks, and this is expected to increase over time,” she pointed out.The other five entities shortlisted for awards in the PSCSC are: National Health Fund (NHF), National Housing Trust (NHT), Firearm Licensing Authority (FLA), National Land Agency (NLA), and the Jamaica Cultural Development Commission (JCDC).The PSCSC, coordinated biennially by the Public Sector Transformation Programme in the Office of the Cabinet, seeks to reward and recognise government organisations that excel in providing quality customer service and by so doing, challenge other entities to raise customer standards. Advertisementslast_img read more