Tips For Better Health Care

Rules of thumb are quick shortcuts to decision making. Often we can’t explain them. It’s just a "gut feeling." Sometimes when we’re trying to be really logical and rational so that we make the "right" decision we discount our gut feelings and ignore quick rules of thumb. And rules can be quite valuable in health care. We will talk about a few quick rules that can serve you well in getting the best care for you and your family. And we will explain the logic behind them, so that it becomes clear they’re grounded in good sense.

Rule One: Avoid Superior Doctors

A superior doctor is not necessarily a better doctor, but he sure thinks so. We all know people in various walks of life who are "legends in their own minds." But in health care, a self-centered, superior doctor can be downright dangerous to your health. Here’s why.

Teamwork is absolutely critical to high quality health care. The technology nowadays is so complex, and the treatments likewise so intricate, that any individual patient’s care can requite the skills of nurses, technicians and therapists, not to mention doctors from numerous specialties. A well functioning team requires mutual respect and regard for all team members, and close communications too.

When one of those team members acts superior to the others, the team no longer functions well.

A nurse, for example, who has had her head bitten off on one occasion, is going to be reluctant later to speak up when she sees something that seems wrong. That propagates error, and error propagates injury, and/or death.

So when you see a doctor demeaning or insulting a nurse or another caregiver, especially in the presence of others, steer clear! That doctor is dangerous to your health.

And don’t just take my word for it. Nurse Theresa Brown wrote a column about this in the New York Times (punningly titled, "Physician, Heel Thyself"), and several letter writers, including a hospital CEO, wrote into the Times to endorse the importance of this simple rule of thumb.

A Rule of Thumb for Scheduling Surgery

You can’t schedule an emergency, but many hospital stays for surgery are non-emergency and can be scheduled. Rule of thumb: Avoid Thursdays, Fridays and nights. Also avoid any time right before your surgeon’s vacation. Best are Mondays, Tuesdays, or Wednesday mornings.

Why? If you are operated on close to a weekend, that means the critical early days of your recovery – when the bad stuff like blood clots, infections and other avoidable complications often happen – are going to be under the domain of the weekend staff at the hospital. There will be fewer bodies to pay attention to you, and more important, they are often second-stringers: Less experienced staff has less seniority and therefore lost out when scheduling time off.

Nights are a similar problem. And if the staff runs short at night, they often try to scrape by until morning rather than getting backup staff out of bed. That can be bad for your health.

You wouldn’t think nighttime surgery would be common. But I have had clients who have been told to show up at night for surgery. From my experience, not a good idea for you.

As for vacations, my totally unscientific personal experience tells me that malpractice events happen more commonly when the surgeon goes out of town right after the procedure. The person who knows best what happened during the surgery is not around, and the substitutes have less of a personal, emotional commitment to your welfare.

The point is the same as avoiding weekends: you want the first string team on your case. They won’t be there on weekends.