Healthcaring vs. Healthcare

My husband was bitten by a spider a few months ago. At first, it did not seem like a big deal, but within two days the site of the bite grew into a painful lump the size of a grapefruit.

It was Sunday morning, and I was convinced that waiting until Monday to see a doctor could be potentially disastrous. We had to find an urgent care clinic right away. I called the number on our insurance card, and after navigating five different phone trees and being on hold for 50 minutes, a real person finally said, “Hello, how may I help you?”

After answering several questions asked by the triage phone nurse, we were told to go to an urgent care clinic in Sacramento. So, we jumped into the car and drove to the clinic that was recommended by the nurse. As we pulled up, I realized the parking lot was empty and the building was dark. They were closed on Sundays.

Frustrated, I called the number on my insurance card again. After another 45-minute wait, the nurse said our other options included bringing my husband to the closest hospital emergency room or driving 16 miles to an urgent care clinic in Woodland. Feeling that Joe’s spider bite did not constitute the kind of emergency that would justify taking him to the hospital where people had real emergencies like heart attacks and severed fingers, we opted for a clinic in Woodland.

By the time we arrived, the clinic was winding down for the day and preparing to close in 45 minutes. However, there was still enough time to get Joe seen by a physician who prescribed him with an antibiotic. By Monday morning, he was in excruciating pain and the lump seemed even larger. I called our healthcare provider which meant weathering several more pre-recorded phone trees, being hung-up on four times, and waiting 70 minutes to secure an appointment. Whew!

At the time of Joe’s in-person appointment, his primary care physician told him that he would have to immediately lance the site of the bite because he was so close to going septic. The doctor openly expressed his frustration at his own health-system’s urgent care clinic because the physician there did not take the time to lance Joe’s wound when she saw him on Sunday. He also said she prescribed him with the wrong antibiotic. “It is completely ineffective,” he told us. “She gave you the antibiotic equivalent of Kool-Aid. No wonder it looks so much worse today.” Disaster was avoided, but frustration was not.

Two weeks later, I had a standing ZOOM appointment with my own healthcare specialist. His assistant is supposed to send a ZOOM link the day before. Periodically, she forgets. When she does, it is unavoidable for me to miss the appointment.

This physician’s office does not have a phone number where people like me can actually talk to someone on the other end. It is all phone trees, all the time. In addition, their phone system does not provide an option to leave a message. Knowing that I could not gain access to my appointment, I hurriedly emailed my specialist in real time to have someone send me a link.

The next day, after missing my ZOOM appointment, I received a text message that said, “You emailed my personal email. Please direct all of your communication to - - . Your credit card has been charged for the missed appointment.” UGH! Two weeks in, and I still have not been able to connect with a live person or get my appointment rescheduled.

These most recent, yet not unusual, encounters have happened during the same time I have been asked to write a review for Dr. Harvey Max Chochinov’s book, “Dignity in Care: The Human Side of Medicine.” In brief, he shares patient stories, not unlike my own, that illustrate how American healthcare has become less personal and less connected to the patients who need more than just procedures, diagnoses, and treatments. They also need to be cared for and cared about.

He argues that meaningful patient care requires equal measures science, art, and spirit. Without any one of those ingredients, the other two will likely be less effective in terms of caring for the whole person. If we in the healthcare industry can focus evenly on perfecting the art and spirit of care, then the outcome will be exceptional customer service that is marked by dignity and human connection: Two qualities that carry a potent punch in helping patients feel better about their healthcare.

Chochinov says, “Anyone working in healthcare having patient contact must remember that their attitude toward patients and families will invariably and indelibly influence the healthcare experience.” Since compassion implies that we have an awareness of someone else’s pain and are simultaneously driven to ease their suffering, the author makes the case that compassion is what separates healthcare from healthcaring. He says, “Healthcare systems are organized around the delivery of evidence-based medicine and are focused on providing skills and services that are largely technical and knowledge-based. Healthcaring, that is healthcare imbued with compassion, implicates not only what we do with or for patients, but also ways of being with and acting toward patients.”

So often, especially in hospice and palliative medicine, the thing that makes patients feel better is not more morphine or the process of tracking and recording vitals, or having more information about their disease, or even increasing the cadence of clinical visits. The power to feel better is usually found in the quality of those clinical visits. It can be unearthed in a gentle touch, asking questions about the patient’s family, asking what is important to them, sinking yourself into a chair next to the patient to see them at eye-level and being inquisitive about their life . . . learning who they are.

Multiple phone trees, computer-generated voices, and long wait times will never contribute to a patient’s sense of dignity or worth. In the short term, it makes patients feel worse, not better.

Chochinov challenges his readers by asking. “What is it that makes us feel human? What makes us feel connected?” The answer to those questions is precisely where healthcare providers need to focus more energy . . . teasing unnecessary suffering out of the system while simultaneously affirming a patient’s worth and dignity. The answer will likely not be found in the use of more technology and the fragmentation of communication.

Shifting to a healthcaring environment requires intentionality to build compassion, dignity and human connection back into every corner of healthcare. As Dr. BJ Miller, founder of Mettle Health, says, “The ultimate goal is for health and healthcare to focus on making life more wonderful, rather than just less horrible. This gets right at the distinction between a disease-centered and a patient- or human-centered model of care. Here is where caring becomes a creative, generative, and even playful act.”

This is exactly why YoloCares has spent nearly 50 years honing its ability to be a healthcaring organization. Our goal is for patients and families to never encounter phone-trees or fragmented and uneven communication. Real people answer the phones and respond to patient needs in real time. While the agency relies heavily on technology for the delivery of care, technology should never become a barrier to access care or connect with another person.

Hospices like ours began as a counterculture movement in the 1970s, championing human dignity for those often marginalized at end-of-life. Hospice care is now mainstream. By 2032, hospice in America is projected to grow into an $80 billion industry annually. It is now big business and high-tech. Perhaps we are still counterculture here at YoloCares where high-tech meets high-touch and healthcare still means healthcaring.

Davis Enterprise