Guest Post by Robert O.
Medical narcissism is a term coined by John Banja in his book, Medical Errors and Medical Narcissism. Banja defines “medical narcissism” as the need of health professionals to preserve their self-esteem leading to the compromise of error disclosure to patients. In the book he explores the psychological, ethical and legal effects of medical errors. He talks about our need as physicians to constantly assert our competence and how this can cause otherwise capable, and even exceptional, professionals to fall into narcissistic traps.
He claims that:
“…most health professionals (in fact, most professionals of any ilk) work on cultivating a self that exudes authority, control, knowledge, competence and respectability. It’s the narcissist in us all—we dread appearing stupid or incompetent.”
Guest post by Shahbaz S.
Does patient satisfaction matter? If you’re a healthcare administrator you’re likely to believe so, as demonstrated by patient satisfaction surveys, hospital greeters and increased vigilance on ensuring enhanced patient satisfaction at all levels of healthcare.
While well intentioned, the premise behind this sentiment may be misguided. There is an idea that enhanced patient satisfaction correlates to better patient care, however, we’re merely muting more deeply seeded issues. By employing measures to enhance patient satisfaction, hospital administers are creating an illusion of better care. If a patient feels that they’re being attended to – they are more likely to view the hospital in a beneficial light.
We’re often taught in residency and medical school that the number one reason for lawsuits and complaints is a lack of communication and dissatisfaction with the physician. I always facetiously interpreted this to suggest you could make many mistakes as a physician, so long as you were nice about it. I use this exaggerated analogy to suggest that efforts to enhance patient satisfaction could be viewed in the same light.
I’d instead, like to argue that a more important element to delivering excellent patient care is healthcare worker satisfaction.
Guest post by Nick C.
According to a Google spokesman, the company’s overarching philosophy aspires “to create the happiest, most productive workplace in the world”. After reading a little about their lofty goals, I thought to myself: boy, we should do that at the hospital. That would be awesome.
Now, like all of you, I’ve had my fair share of fantasies about getting a job at the Googleplex. If you don’t know what this is, Google it and spend some time dreaming about sipping unlimited free organic-soy-no-foam-extra-hot-lattes while on route to a massage, followed by a power nap during the middle of your workday. Free food, video games, exercise classes, and ping pong are just a few of the ways in which Google is trying to keep their employees “happy” and thus more productive. And productive they are! In 2014, according to the Interbrand ranking, Google was the second most valuable brand in the world (behind Apple) with a valuation of $107.4 billion. So what are the key contributors to this company’s success? While they appear to have created the perfect work environment, and were recently voted the top company to work for in America by Fortune magazine, there is a little more to their strategy than that. When Google established itself as a company in 1998, Larry Page and Sergey Brin (the founders) compiled a list of “Ten Things We Know to be True”. This list has served as a mission statement, which ultimately guides the company’s goals, culture, and decision-making. Despite being a multinational corporation with approximately 50,000 employees, the top executives continue to revisit this list periodically to ensure that their 10 truths still hold true.
Came across this excellent article that discusses why in the age of well-educated individuals with easy access to information (both reliable and unreliable), so many well-meaning people still doubt scientific facts and expert consensus.
The conclusion is eye-opening, and is in line with other studies like this one that demonstrates solely using logic and scientific facts on disbelievers will likely be ineffective in changing their minds. Even in the face of outbreaks, antivaxxers appear even more vocal about their stance on conspiracies and general mistrust of leading experts.
Guest post by George M.
Bed pressure: anyone who has worked in the Emergency Department has felt it. I make a routine practice to come in for my shifts 15 minutes early and find a dark corner of the ED where I can “take the temperature of the department” and get a sense of the day’s pressures. On a day with heavy bed pressure there’s a frenetic buzz in the air, a tension that is almost palpable – everyone knows we are working in a crisis situation, and you can feel it.
Recently, I worked a shift where we had 3 available beds in our 20-bed module within the ED, and about 8 available beds out of 60 department-wide. That’s serious bed pressure. In my corner before my shift starts, I see the charge nurse pass by and he looks just a bit more harried than usual. The department board has an overall look resembling a highway at rush hour. The Emergency Physician on the outgoing shift mentions to me that she is “trying to tidy up” and handover might be delayed, because she doesn’t want to burden me with risky follow-ups when she already knows the state of the place and what I’m going to be facing over the next nine hours. On this particular day, our nurse manager even had 5 admitted patients waiting in the departmental boardroom to try to free up space.
The health care professions have finally begun to revolt.
Over the recent years, medical associations have mustered up the courage to publicly denounce the value of having employees and students alike dragging their sick bodies into a doctor’s office (or *gasp*, an Emergency Room!) for the sole purpose of obtaining a sick note. The Ontario Medical Association officially issued their plea early this year, and Doctors Nova Scotia quickly followed suit.
And for the first time, an individual physician has started to take action by attempting to charge employers for sending their employees into the office for sick notes off work.
Guest post by Shahbaz S.
John Arnold, in Jurassic Park likely said it best; “Hold on to your Butts”. This is going to be a long rough winter inside Canadian Hospitals, because Ebola isn’t likely to kill Canadians, but Influenza certainly will.
In Medicine we rely heavily upon the media to help disseminate information and policy to the public, but unfortunately I suspect that they are currently doing more harm than good. The current Ebola crisis has taken over international news, and seems to be on the forefront of everyone’s minds; but are they setting us up for a potential disaster?
In the ocean of criticism and negativity around our health care system – ranging from escalating cost to wait times – once in a while you come across an island of refreshing positivity and reality.
If you haven’t read this article published in the Ottawa Citizen, I highly recommend it. It should be mandatory reading material placed in waiting rooms across the nation, to serve as a reminder that things work, well, “pretty damn well”.
Social media went a little bit nuts recently. Newsfeeds on multiple platforms were flooded with short video clips of individuals dunking ice-cold water onto themselves (or variations of), all in the name of raising awareness and funding for ALS.
And like all viral trends, the skeptics and critics weren’t far behind. Check out this opinion article published in the Canadian national magazine Maclean’s, where the author questions the wisdom of such sudden generosity given to a disease that affects so few people. Or more drastically, see here for the first mortality linked with performing the ice bucket challenge.
Unsurprisingly, a counter-criticism of sorts has since started in response, accusing the naysayers of being bitter whiners who complain for the sake of complaining, and that anything that helps ALS awareness and research is worthy of praise.
Physician-assisted death and euthanasia is not a new topic of discussion, but is creeping to a tipping point in Canada with recent legislative decisions (see Bill 52 in Quebec, and other bills tabled). Anyone who has had experience with end-of-life care, whether personally or otherwise, would understand the complexity of the issues involved. If you haven’t already, have a read through this article published on HealthyDebate which nicely summarizes some of the key issues in the debate.
What struck me most from the article are the following points: