We celebrated a 100th birthday around my Aunt Kikke, born during WWI in the Netherlands. She interrupted medical school and then emigrated to the US when the Nazi’s invaded. She couldn’t get into medical school here because she was a refugee, a woman, and a Jew. She was finally accepted to Johns Hopkins Medical School on Albert Einstein’s recommendation. Yes, that Albert Einstein. Aunt Kikke, Kato van Leeuwen, practiced as a psychoanalyst through her 90’s. The US has thrived throughout its history from the inspirational careers of refugees and immigrants such as my Aunt.
Posts by Danny van Leeuwen:
Who knew he loved penny whistles? The pianist who accompanied his cello-playing friend on piano for years told a story yesterday at his funeral. At Christmas last year, this father who I knew as awkward, serious, unemotional, religious, conservative, classical music-loving, got the church choir penny whistles and led them in a performance of Good King Wenceslaus. While the story was told, the priest pulled a penny whistle out from the pulpit and tweeted a few notes. “It’s there to keep me humble.”
I consider myself a good read of people. 50-75% of the time I’m spot on (That’s 25-50% spot off). It leads me to an occasional empathy-challenged state. A penny whistle can tip the balance.
Happy Father’s Day all you fathers. I love the father in my sons. Here’s to you, Cliff, a faithful reader of this blog. You’ll be missed!
I read a post this week on the Society of Participatory Medicine’s blog about a nightmare attempt to obtain medical appointments as new patients. You’ve faced the poor listening skills, conflicting information about the availability of appointments, lack of sharing information about you within the clinic or insurance company, poor or no follow-up, waiting, waiting, waiting, that the author describes.
I’ve dealt with it, too, as a patient, caregiver, clinician, and quality management leader. So, how do health care clinics and insurance companies know about the challenges their patients/customers live through? The most common is through surveys. Surveys are blunt (not sharp) and fairly useless. Most health plans require clinics to administer the CGAHPS Clinician and Group Survey. Three questions on the survey include:
- Patient got appointment for urgent care as soon as needed
- Patient got appointment for non-urgent care as soon as needed
- Patient got answer to medical question the same day he/she contacted provider’s office
You can answer Never, Sometimes, Usually, Always.
Most health plans survey patients about health plan service:
- In the last 12 months, when you needed care right away, how often did you get care as soon as you needed?
- In the last 12 months, how often did you get an appointment for a check-up or routine care at a doctor’s office or clinic as soon as you needed?
- In the last 12 months, how often was it easy to get the care, tests, or treatment you needed?
See, not very informative. A score might be more than 80% of patients say Usually or Always? That could mean that 19 of 100 people responding are unhappy with their experience. Wow. How can anything be changed based on that result? More
If I was queen for a day, with a genie, and a clean slate…
The practice management staff of XYZ clinic routinely runs a program of all their patients’ data to predict those at risk for needing urgent care or hospitalization. The practice contacts Alice (one of many such patients or caregivers) pointing them to their practice portal or speaks with her on the phone with the module open to them. A module in the portal or caller from the practice asks Alice to confirm the accuracy of the data and allows or asks her to correct or fill in information used in the screening program. Alice can type or speak her responses. The module or caller asks questions about the current status of her treatment plan (activity, diet, meds, appointments, etc.), her current abilities and symptoms, and asks her if she has questions. Depending on the answers, Alice may be instructed to go to an Emergency Room. If she needs Urgent Care, another module opens up to a clinician immediately available by video who has access to the same data as Alice and her answers to the clarifying questions. They discuss her status, make decisions, order tests and meds as needed and update her treatment plan. If she needs neither emergent or urgent care, her next appointment at the clinic is confirmed or scheduled and Alice is reminded of her treatment plan and schedule and pointed to activities and community resources that may be of value in the meantime. When Alice arrives at the clinic, her clinician views the entries in the portal module with her and they discuss her status, make decisions, and update her treatment plan. For any of the scenarios, Alice’s questions are answered live or via the portal. Costs and out-of-pocket expenses are included. More
OMG, I’m upgrading my website. I started the blog almost 5 years ago setting up the website with help from my friends Eric and Jodi (this is my 305th post). Now I want more from the website. I’m adding two pages: Portfolio to share my articles, guest posts, interviews, and projects. How Can I Help You? For topics we care about and related resources. I’m determined to create it myself – much like my wife and I built a house – seriously ignorant, reading instructions, tutoring, advice, and making significant mistakes while putting one foot in front of the other persistently. Learning something completely new is a frustrating gas. Frustrating until you learn a bare minimum of the language, get the right tools, building a support team, and finding the growing mindset of I can do this!? Frustrating when you mess up big time – like a couple of days ago when I unknowingly loaded 13 sample posts with my new theme and they went out to all of you looking like spam. (Thanks for letting me know and hanging in there with me.) A gas when you stumble upon or are pointed toward a solution, when you can find the solution a second time, when you can start to see the creation, and when someone else appreciates it. Gosh, this sounds like living or supporting someone with a chronic illness, living in another country or community, playing music, going to school, or starting a new job. More
Pound for pound, the best health conference! A rare combination of small, local, action-oriented, inspiring networking, and relaxing. 40-50 attendees met in Grantsville, Garrett County, MD, population 766, for three days. Regina Holliday of Walking Gallery fame organizes and breathes life into Cinderblocks. The older I get, the more I seek people who collaborate to solve local problems that matter to them. 50% of the 30 presentations were literally local – from Garrett County and immediate vicinity. The rest came from as far as France and LA, Oklahoma, Texas, Boston, and DC to learn what works for each other. A sample: More
Screenwriting seems like such an opportunity. The storyteller imagines a dilemma, a journey, a cast of characters, and a community. They picture what will happen and presto – a play, a movie, a video. Everyday people have a health dilemma, find themselves on a journey, with a cast of characters, in a community – real life scenarios of care. More
Pissed off only begins to describe my reaction to the passage of WealthCare, TrumpCare, RyanCare. How about outraged, furious, despondent, bewildered. My frame has always been: Everyone has a right to basic health care. How can we align the forces of this great and diverse country for best health for all? More
You know I love stories, telling and listening. Especially stories of people on a rough health road who take the fork to advocacy and community organizing. Advocacy and community organizing isn’t for the faint-hearted. It’s a tough business. Passion and lived experience are necessary, but not sufficient. Advocacy is a struggle. We need lessons learned from advocacy experts. More
Advocate, Caregiver, Informatics, Patient, Researcher Best health, care planning, caregivers, Data, ePatient, evidence, goals, health team, innovation, learning, shared decision making, storytelling 2
I’m the son, Custodian, and Healthcare Proxy of my 89-year-old mother, Alice. I live in a different state. My mother has diabetes and is depressed. Her care team, besides herself and me, includes medical providers in various health settings, community support agencies, and a full-time caregiver that helps her schedule and get to health-related services. My problem is to understand what my mother wants for herself and to track who says they’re doing something for her (including my mother and me), what they’re doing, and when they’re doing it. I want to know what it takes to do it (Can she afford it? Can she get there? Does it agree with her? Who will be with her? etc.). I want to know if the actions have the effects we thought they would. I want to know what her risks are and how we plan to prevent or respond to them. I want to able to keep track of all this and keep it current. I want to share it or have it shared from day-to-day and from setting to setting even if I’m not present. More