The Broke Surgeon

Today, I actually do not want to talk about our healthcare system. With  the changeover of the year, I want to use this time to reflect on my own  life so far and where I see it going in the future. Not that today is  any special day. Today is just another 24 hours of the Earth spinning on  its own axis. But we assign something special to this time of year with  the use of our completely made-up calendars. And so, with 2022 being a  thing of the past, perhaps it does make some sense to reflect on the  past and take a look ahead into the future.   

Books: 

Arnold Schwarzenegger's Pump Daily newsletter:  https://schwarzenegger.ck.page/0943ca5e13  

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Here is something I absolutely do not understand: blanket masking rules  in healthcare facilities. Within the same county even, I go to  facilities where I don't have to wear a mask. Some I do. Some I even  have to wear N95s. There does not seem to be any rhyme or reason for any  of it because, at least theoretically, all of this is guided by the  risk level in that county. And why are we only masking in healthcare  facilities?   

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Narcotics are not bad. It's true! For acute pain, such as when you  just broke your leg, were involved in a car accident, or suffered a  gunshot wound, narcotics are great for reducing your fresh pain and  seductively lull your brain into a sense of comfort at the same time.  But we have begun using narcotics as a crutch for other "acute" pain  such as when a patient needs to work with physical therapy. We are  assuming that nothing should ever hurt. We are scored on how well we  treat pain because pain is, apparently, not an accepted part of life.

But without life, there would be no pain. And without pain, is there life?

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We have all heard that a breakdown in communications is the number one reason for medical errors. It probably is the number one reason for errors in all parts of life. I bet most wars started because of failed communications. For me, I know that I have been struggling with good communication skills for most of my adult life and it's an area that I am actively working to improve. As humans, we have communicated with spoken language for over ten thousand years, and yet, we still can't get it right. And in today's world, where we have audio, visual, and text communications at our fingertips at all times, the quality of our communication seems even worse. Why is that? Why are we so bad at talking with each other?

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Kristin is both a patient and a nurse and, as such, has an incredible perspective of our healthcare system. Please join me in listening to her experience and some of the changes she would like to see.

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The latest isn't always the greatest but what do you do when you can't solve a problem using the old and cheap stuff?  

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What I want to discuss today is acknowledging the limits of our knowledge. It is perfectly okay to tell a patient or family member you don't know something.   

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Yesterday at the gym, a mom had to bring her daughter into the weight room because she didn't have any childcare. And while most people probably thought this was either a liability to the gym or dangerous for the child, I thought, what better way to teach our kids the value of exercise!

Exercise ... we all know it's part of a healthy lifestyle. But do we truly get the exercise we need? Do we even know what exercise we are supposed to get? And if we adults don't get this right, how can we ever expect our kids to learn?

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An ounce of prevention equals a pound of cure. We've all heard it. We all say it. We all pretend that preventive medicine is the best medicine. But what we are mainly practicing in the United States, and possibly the rest of the world, is reactive medicine: we react to a problem when it arises.  

So what exactly is preventive medicine? Do we want it? Why aren't we doing it?  

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ICD-10 ... it's the code which classifies and categories patient diagnoses and problems. For example, it's not enough to call something a venous leg ulcer because no one would be able to understand what you mean. But if you say I87.319, chronic venous hypertension (idiopathic) with ulcer of unspecified lower extremity, then all of a sudden everyone knows exactly what problem you are talking about. Of course, you can be even more specific by using either I87.311 or I87.312 if you actually know which leg, left or right, the ulceration is on.   Classifying diseases can be both useful, such as when trying to analyze large patient data sets, and mind-blowingly painful, such as when patients don't fit neatly into one of the over seventy thousand categories provided by ICD-10.  Why are we using such a weird system? Is it really the best we can do?   

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Twitter: twitter.com/felixboecker