Five Minutes to Fix Our Broken Healthcare System
[Music]
so i went on this date with
a guy i met online good on paper
worst date ever
he shows up late barely says hello
hardly lets me talk before probing me
with a barrage of questions
and then he just walks out
and who gets left with the bill worst
date ever
undeterred i continue to online date
and i go out with this other guy also
good on paper
but this one led to a long-term
relationship
he shows up with a warm smile asked me
about something he found interesting on
my profile
and then we engage in meaningful
conversation about each other’s
histories
the difference is clear one treated me
like
an objective the other treated me like
a person these are true stories about
experiences i’ve had
but i did lie about one little detail
these weren’t dates with men they were
appointments with doctors
i spent 10 years doctor dating
searching for a diagnosis to make sense
of my mixed bag of chronic symptoms
it wasn’t until this last doctor that
someone had intentionally asked me about
my life outside
of my standard medical history and
therefore was properly
able to diagnose me with fibromyalgia
so what’s the message here that a good
on paper guy
can be misleading definitely true
but deeper than that whether
relationship is romantic
or clinical research shows that there
are
three essential qualities to every
successful relationship
respect communication
and trust this is true for couples
friends
partners parents and yes doctors too
unfortunately doctor-patient
relationships
aren’t prioritized like our other
relationships
it’s not the doctor’s fault it’s not the
patient’s fault
it’s the nature of our faulty health
care system
now it’s not news that our healthcare
system is broken
and it is a multifaceted issue
but deeper than the obvious complexities
and disconnects
there is a crack in the foundation
that we often ignore a crack that can’t
be patched up by
better technology more money a private
or a single-payer system
but it can be fixed by us
doctors are people patients are people
we
as people can take part in fixing our
broken health care system
because we make up that system
we don’t need legislative change to have
better doctor-patient relationships
although many would argue that we need
more time
a doctor’s appointment rarely is longer
than 15 minutes
so the question to fix our foundation of
healthcare
isn’t only how do we build stronger
healthcare relationships
but also how do we do so quickly
and efficiently today i’m here to share
with you a tool
that takes only five minutes
my professional experience in healthcare
as a researcher and my personal
experience as a patient led me to create
a
tech company that uses compatibility
matching just like a dating site
to help people with chronic illnesses
find
their ideal doctor-patient relationships
in preparing for today
i asked our doctor and patient users
what their issues are with the
healthcare relationship as it is the
majority of our patients
agreed upon this sentiment
i feel like doctors don’t care to
understand me
now i want you to imagine for a second
that we’re talking about a marriage
or a life partnership if your partner
said to you
i feel like you don’t care to understand
me wouldn’t that be a
giant red flag that something’s wrong of
course
but would we ever say that to our
doctors
so let’s look at it from the doctor’s
side what’s their experience
well doctors have spent 10 plus years in
grueling training
in which they have had almost no money
time autonomy and then as they grow into
their professions they have to retain an
ever-growing encyclopedia of medical
knowledge they have to emotionally
engage and detach from dozens of people
each day
and at the same time keep in mind
financial legal and time constraints
they have dedicated their lives to
helping others
people don’t become doctors to
self-serve they become doctors because
they have a passion
to help those in need
so our doctors what did they what were
their greatest complaints
their comments all boiled down to i feel
like patients don’t understand
my limitations
they’re in a tough place patients are in
a tough place
they don’t understand me versus they
don’t understand my limitations
both feel misunderstood and unheard
respect communication and trust are
absent
no relationship can thrive like that
so how do we close this gap in
understanding
when i was in college as a neuropsych
major my
family cardiologist let me set up a
study
summer study internship in hispaire
office
i was interested in studying the
definition of happiness
based on expectations so it went like
this
i’d go up to people in the waiting room
introduce myself
hey i’m eva dr smith’s intern
would you be interested in joining me
for a few minutes to answer some
questions
they’d follow reluctantly and confused
clearly thinking why is this girl
bothering me
so i’d usher them in have them sit
across from me and then i’d have them
choose
a happy level face that best identifies
how they feel
the majority of the time
i’d then explain i’m going to have you
reflect on 10 different life
circumstances
please tell me if at this time your
expectations whether or not they have
been met
unmet or exceeded i’d ask them about
their
career their family life their health
and then i’d ask them to review each
again
and rate each in terms of importance
basically how much did
them how much do they matter to you in
the first place
and lastly i would ask if there are any
extenuating circumstances
extreme things going on in their lives
positive or negative
that would greatly influence how they
currently feel
things like divorce a promotion a baby
my study supported my hypothesis
one’s level of happiness is defined by
their expectations
boom success
but the real success came from the
outcome
of conducting the study itself
in five minutes in a simple
questionnaire-based conversation
i had a 360 degree view
of each person’s world way beyond their
health concerns
one woman even admitted to me now you
know me better than my best friend
is that all it takes five minutes
structured conversation active listening
what if our doctors knew us better than
our best friends
what if my doctor had would i have been
diagnosed sooner
there’s one interview i’ll never forget
this man joe a recent immigrant from
south africa
he was actually intrigued when i asked
him to participate in the study
but despite his cheery disposition
joe chose this face
so when it came time for the last part
of the study
extenuating circumstances i said to joe
you seem to be a relatively happy guy
joe your expectations have been met
or exceeded in almost every aspect of
your life
except family life which you’ve also
rated
of high importance if you don’t mind me
asking
what is it about your family situation
that seems to have negatively impacted
your happiness so much
last year my family moved from the u.s
to south africa to protect
my daughter from the rising crime in our
country
shortly after we moved to the u.s my
daughter
was killed
yes i am a generally happy and positive
guy
but the pain of losing my daughter
inevitably impacts my happiness
so i try not to talk about it
joe came to see his doctor that day for
unexplained
chest pain tess weren’t showing
any signs of physical issues so his
doctors had recommended that he take
aspirin in the meantime until they
figured out what was going on
joe hadn’t told any of his doctors
about his daughter he didn’t think it
was relevant
and doctors didn’t know to ask he seemed
so
happy but in five minutes
joe trusted me an intern a stranger he
didn’t know
because i had asked the right questions
to trigger a trusting relationship
which made him feel comfortable enough
to divulge helpful
context to his chest pain
relationships whether they’re at home or
in the workplace or wherever
are the greatest contributors to our
happiness
if our happiness affects our health and
our relationships
affect our happiness how can we ignore
the necessity of relationships
in our health care the answer
is we can’t
doctors patients all of us
are equally responsible for the
healthcare relationship
just like any relationship
knowing that how do we take action
at better addressing this responsibility
how do we bring
respect communication and trust back to
the healthcare relationship and how do
we do it
in five minutes
patience you can take action by first
recognizing that your life outside the
exam room matters
you don’t have to tell your doctor your
whole life story but if it matters to
you
it’s important even if it seems
medically irrelevant
advocate for yourself don’t be
intimidated
that’s just another person with a
stethoscope around their neck
a person who does care who does want to
help and understand
so do it together you’re in a
partnership
and doctors you can take action by
using this tool a an in-person
brief but inclusive questionnaire method
it could save you countless hours
dollars and frustrations when you do
but you can adapt it to your own style
adapt it to your patients
for instance pediatricians you can ask
kids to give a
thumbs up or a thumbs down when asking
them about school
siblings bedtime ask more
listen more be curious
there’s more to a person than what’s on
their chart
and often they won’t share with you
unless you ask
if joe had never exposed his
heartbreaking story
he would have been prescribed even more
unnecessary tests
and medications instead
he shared his emotional pain with his
doctor and found
the proper relief in therapy
when the qualities of a successful
relationship respect communication and
trust
are present between a doctor and a
patient
the impact is astounding
quality of life improvements better
treatment outcomes
fewer readmissions more efficient time
appointments
when we get to the true problem faster
there’s a financial benefit to the
individual
and the system and true understanding
may only take the time of a few curious
questions
yes we would all love more time with our
doctors with our patients
but regardless of when or if
that ever happens we can fix our broken
health care system
now by bringing human care
back to health care thank you
you