Monday, April 8, 2019

In Search of Compassionate Care #DrDonDeForge~No. 36

Donald H DeForge, VMD
17 Seemans Lane
Milford, CT 06460

Tri-state Oral Consultant in Advanced Oral Medicine and Oral Surgery
Fellow of the Academy of Veterinary Dentistry
Practice Limited to Dentistry
Immediate Past President of the Society for Veterinary Medical Ethics

In Search of Compassionate Care
Donald H. DeForge, VMD

Image result for Picture of an animal doctor with a patient who is ill

 Human medicine, veterinary medicine, and other allied medical fields have reached epic levels of sophistication and specialization!

There is no upper limit! Top researchers and clinicians combine to find answers to cancer; diabetes; Alzheimer’s; Parkinson’s disease; and a plethora of painful conditions.  Organ transplants and cloning continue to advance to extend our years, on planet Earth, with quality of life.

With a plethora of specialists in veterinary medicine, our companion animal population continues to recover more quickly from serious disease; life expectancy continues to increase; and more pets have quality pain-free lives.  Surgical teams with criticalists in consultation with animal internists lighten the pathway to recovery.

What is lacking in the New Millennium in all areas of medicine is COMPASSION!

 Medicine is synonymous with multi-taskers.  Veterinarians are burdened by clinics; surgery; urgent care; critical care; and ER patients. They live in a framework of management bureaucracy.  Somewhere in the mass of this struggle the word COMPASSION has been forgotten.  This is not just a veterinary problem but also a major problem in human medicine.  Too many patients and not enough time leads to “impersonal” care.
The day of the human general practitioner visiting your home has decreased by 90%.  There are communities with local clinics and home visits but they are few and far between.  At one time, the human physician examined all systems and treated all problems.  With specialization, the orthopedist does not want to hear about a prostate problem.  The hand surgeon does not want to hear about your back pain…..etc. etc. etc.

Articles have been written on burnout, suicide, and compassion fatigue.  None have proven answers. The fact that we continue to write about these issues can hopefully encourage human physicians, human dentists, other health care professionals and veterinarians to seek help before it is too late.

We must not forget that COMPASSIONATE patient-care considerations are linked to treating others the way we would want to be treated. We owe it to our patients to never abandon them with a lack of COMPASSION.
When Doc visited my Dad who was a stroke victim, he sat and chatted and had a cup of coffee before leaving.  When the dentist came to our home to remove an abscessed tooth from my Dad, he did not just walk away but sat with my Dad and joked and told stories about what it was like “in the day” when they were growing up.  Compassion to the stroke victim isn’t as common today within the “sterility” of corporate practices.

Technical, biomedical, and financial issues are areas in which physicians and veterinarians find a comfort zone.  COMPASSION and other emotional care problems have become ”major discomfort areas”! They are intangible entities and take time to solve.  These issues decrease the amount of patients seen each day.  They are “not for profit” areas of care and that bothers medical facility management.

The intangible must become tangible.  Compassion does not belong on a multi-task list.  COMPASSION is a uni-task or a mono-task.   Years ago and even today, the veterinarian sought the multi-tasker and was the ultimate multi-tasker. In the New Millennium, the veterinarian must transition from a multi-tasker to a mono-tasker. Searching for COMPASSION is a mono-task.
Before anyone can mono-task, they must temporarily each day disconnect from the electronic world and initiate focus tasking:

1] First and foremost shut off the Smart Phone

2] Walk away from your desk-top and the other multi-problems sitting on your desk for completion

3] Put a pause on answering messages; writing E-Mails; consulting with your head technician or physician’s assistant; or meeting with your practice manager

4] Set COMPASSION goals.  Review these goals weekly with staff to see if any or all of the goals have been achieved.

All of this is to strengthen the meaning of the doctor-patient relationship. Separating oneself from an anxiety centered multi-tasking world and mono-tasking can lead to harmony and initiate feelings of compassion. Finding compassion in meditation has been found helpful.
A recent study by Northeastern University’s David DeSteno confirmed what Buddhist theologians have long believed---meditation can lead you to more compassion, love, and a commitment to end suffering for oneself and others. 

The concept is that the mono-task meditation exercise improves attention and the ability to focus one’s attention to specific areas of the work environment…..i.e. COMPASSIONATE CARE!  

In humans medicine, this is a reflection concerning ALL patients [i.e. the well insured and those without insurance] and in veterinary medicine to all members of the Animal Kingdom!

The ultimate question is:  Can compassion be trained and learned in adults?

One researcher compares it to flexing our “compassion muscles” every day.
We build up the “compassion muscle” and respond to our patient’s suffering with greater care and desire to help.  

Veterinarians find themselves holding their patients with loving care and talking to their patients after surgery or a medical test and not just returning them to the medical-surgical wards.

Veterinarians have to accept a TOTAL commitment to becoming “Voices of the Voiceless” and finding creative ways to help clients who love their pets but have financial difficulties.  This is not easy!  A team member can be assigned to this important task under the supervision of the hospital manager.

Human physicians MUST find ways to stop double and triple booking by adding new doctors and physician assistants to their group.  They MUST report abnormal lab tests compassionately with a personal phone call to their patients and not relegate this task to one of the nurse assistants at their practice.
Human physicians must take on a GREATER ROLE working with insurance companies to have testing approved that is relative to diagnosis and patient care.  This is time consuming but it is essential in returning COMPASSIONATE CARE to medicine.  Insurance obstacles should not become a problem in providing care.  Everyone is entitled to excellent diagnostic care and appropriate treatment without insurance restriction.

The positive extension of leadership compassion is that it grows!  It is embellished by all nurses, assistants; technicians; and client service representatives as it is exemplified by practice management.

This same model will be successful in any workplace.....not just human or veterinary medicine!  Consider bringing compassion to your workplace; to your school; to those that you meet and greet each day!

Leadership compassion originates from mono-tasking and focus-tasking in compassionate care.  It is the answer!  “Only when we give joyfully, without hesitation or thought of gain, can we truly know what love means.” Dr. Leo Buscaglia

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