Are We Truly Measuring Patient Satisfaction?

I was struck by an op-ed piece I read recently in the New York Times. The author, Theresa Brown, RN, in her piece entitled Hospitals Aren't Hotels, opines that we set unrealistic goals in medical treatment when  patient satisfaction scores are the primary measure of success. Is patient satisfaction  always correlated with more expensive or aggressive treatment?  Perhaps we need to redefine satisfaction? Can we shift our model of care from a "doing for" model to a "being with" model and still achieve patient satisfaction? Do we, as Theresa Brown suggests, always need to first hurt in order to heal?

 Lots of food for thought here...would love to hear your comments!

The Rituals of Healing

Do you notice the rituals of healing in the same way as you notice the rituals of religion? It is interesting to think that rituals play a large role in the healthcare system, and perhaps in our ultimate healing. What do you consider the rituals of healthcare? Perhaps the white coat and stethoscope? The physical exam?  Receiving of a prescription for a medicine?  I have been reflecting on what we consider rituals related to the healing process as I have read and watched some interesting remarks on this subject from two leading sources on this topic.

Dr. Ted Kaptchuk, the director of Harvard's Program in Placebo Studies and Therapeutic Encounters, was recently interviewed in the New Yorker magazine about his quest to understand the placebo effect and how it influences quantifiable measures of health.  Could our belief about whether a treatment is effective or our level of trust in routine rituals of healthcare, such as placing a stethoscope on the chest, physiologically change our ability to heal? 

Dr. Abraham Verghese, author and physician, ponders whether we, as a society, are in danger of losing the art of medicine as we have increased access to technology to support the science of medicine. In his recent TED talk,  Dr. Verghese argues that while it is important to have modern tools of medicine, which are enabled by science and technology, the art of medicine is essential as well.  For it is the art of medicine that allows for the human connection between patient and healer to emerge and the rituals of healing to be sustained.

What are your thoughts?

Arts of Compassion

Mark your calendars! Arts of Compassion: Perspectives on Arts and Health is an upcoming symposium scheduled for Saturday, October 2, 2010 at the Berklee School of Music. The Longwood Symphony will also be performing after the symposium. The symposium is being sponsored by BACH (Boston Arts Consortium for Health). This promises to be a wonderful day of inspiring speakers and moving music!

Nurses Lead the Way With Health 2.0 Chronic Disease Initiative for Teens

If you have observed teens in the last 10 years, you will know that most teens prefer texting to talking on cell phones. It is this observation that led Visiting Nurse Service of New York to propose an innovative chronic disease management tool for teens with Type 1 diabetes (insulin-dependent diabetes) using aspects of health 2.0 and social media. The pilot program, which will run for two years, supplies each teen with a BlackBerry smartphone with specific interactive diabetes tracking software installed. The teens will be tracking and monitoring their blood sugar and diet information into the BlackBerry and the data will be monitored and analyzed by visiting nurses with the hypothesis that more frequent monitoring by teens with diabetes will lead to better health outcomes and fewer complications of diabetes.

Kudos to the Visiting Nurse Service of New York for embracing a creative use of new technology to provide better disease management to a very wired target market! How do you envision tools of technology and connection being used in healthcare?

Check out a video about the pilot program by clicking here.

Let Me Down Easy....What is Grace?

What is grace?...That is the overarching theme and question that resonates in Anna Deavere Smith's new one woman dramatic work Let Me Down Easy: a play in evolution currently being performed through October 11 at the American Repertory Theatre (Loeb Drama Center Harvard Square) in Cambridge, MA. I had the incredible experience of being in the audience on September 16 to witness and share in the journey Anna leads us through during the two hour performance. Through the stories and voices as varied as Ann Richards, former governor of Texas to Matthieu Ricard, a Buddhist Monk; from Jean Damascene Uwikijie, a Hutu prisoner in Rwanda to Dr. Phil Pizzo, Dean of Stanford Medical School; we are confronted with looking at ways in which our bodies and souls are both resilient and vulnerable. A sense of wonder, beauty, stamina, fear, grief and courage shine through all the vignettes...a snapshot into simply being human. "The only whole heart is a broken one, it lets the light in..."says the voice of Rabbi David Wolpe in Let Me Down Easy. Perhaps this is the essence of grace, to open oneself to the frailty and resilience of the human spirit with compassion and awe. What does grace mean to you? I would love to hear from you!