Monday, April 10, 2017

There is no 'Health' in Healthcare

My Dad is in the hospital again. Being there with him over the last few days reminds me of all the reasons I left my job in the healthcare system. I’ve said this many times in my career, but I’ll say it again. A hospital is the last place you want to be if you are sick.

Despite their marketing claims to be a place of healing, in my experience, hospitals are only worried about two things: getting paid and getting sued. And the majority of decisions and policies made within hospitals are based on those two primary concerns.

Even though they want you to feel like you are getting personalized care, the reality is that hospitals are institutions, just like schools and prisons. And like any institution, they have created an elaborate web of rules and protocols that sacrifice the rights of individuals under the pretense of protecting their health and safety.

I understand that it is hard to manage all the potential risks in such a large facility. And to account for the fact that everyone does not view the world in the same way. People can do crazy things sometimes. But when you are a normal person like my Dad, who is just trying to get better and go home, the hospital can be a very frustrating and stressful place. And that is not the type of environment that promotes healing.

Through my yoga background and my experience dealing with my own health issues, I have learned so many tools for connecting with my body and giving it what it needs to be healthy. I try to take the time to notice how I am feeling and respond with activities that complement, rather than fight against, whatever I am experiencing. If I am starting to get a headache, I will drink some water and have a snack before I reach for the Motrin. If I am feeling overwhelmed or anxious, I will stop and take a walk instead of ‘powering through’ whatever I am trying to get done.

Unfortunately, that is not the philosophy of the modern day hospital. Here is what I have seen so far with my Dad:
  • There is no holistic view of his health. Each doctor only focuses on their specialty and their issue. The cardiologist looks at his heart. The urologist looks at his bladder and kidneys. They do not seem to recognize or acknowledge that these systems are related. 
  • There is a pill for everything. As soon as my Dad shows any new symptom, the doctors come in and tell us which medicine they are going to give him to fix it. They never discuss any natural or alternative remedies that could help his body heal on its own. They just want him to stay on the medicine, and then they don’t have to worry about actually practicing medicine.
  • No one seems to be concerned about the underlying cause of his symptoms. When we ask why certain things are happening, like when he developed an erratic heartbeat, no one can explain it to us. They just want him to take more medicine. But the medicine just masks the symptom or replaces the body’s natural process with some sort of synthetic substitute. It doesn’t heal his body or help his body to function better. 
  • The doctors are not proactive. Everyone seems to treat what is right in front of them without thinking about the consequences. If the treatment causes something else down the road, they will deal with that later. My Dad was labeled as a “fall risk” so they won't let him get out of bed. But if he is bedridden for four days, he is likely to get weaker and possibly develop pneumonia or fluid in his lungs. Instead of preventing this by letting him walk with supervision each day, they force him sit there in bed until “Oh, surprise!” Now he has pneumonia and they can treat it (with medicine of course.)
There are so many things wrong with the healthcare system. It is overwhelming to think about. I have been aware of all of these problems for years, but watching my Dad go through this and knowing there is nothing I can do to help him has left me feeling tired and frustrated. I just want my Dad to get better. And I want him to have a positive experience in the hospital while his body is trying to heal.

Luckily, there have been a few doctors and nurses who have been helpful to my Mom and Dad. They are the rare exceptions who take time to explain things and communicate with each other to try and put together the whole picture. But the way the system is set up, it is not easy.

If I could redesign the modern hospital, I would create a holistic center for wellness. In addition to offering medical treatments, it would focus on natural and alternative therapies. Every person would have a device in their room to look up treatments and their side effects and talk about them with the provider. The provider would have to go through the list all of the health issues the person has, and they would be required to discuss how the issues might be related. Prescribing medicine would be the last resort, instead of the first line of defense.

There would be healing patios located throughout the facility and windows in each room that would open to allow fresh air in. Every person would have a chance to go outside at least once a day and feel the air on their skin. And if they are too sick to leave the room, the staff could open up the windows for them. There would be diffusers with essential oils as well, to provide healing benefits and a pleasant scent for the room.

The food would be made to order and come from fresh ingredients grown locally. There would be a kitchen on each floor with a cook designated to make the meals for that floor, instead of trying to make everything downstairs in the cafeteria and keep it warm on a tray. When possible, people might even walk down to the kitchen for their meals instead of eating on a tray in their room. It would all depend on how they are feeling that day.

And people would be able to wear their own pajamas instead of a scratchy green hospital gown. I could go on and on inventing the perfect healing retreat for people like my Dad. But it only exists in my mind. And maybe in a celebrity rehab center somewhere outside of L.A. For real people, there is no such place for healing.

Even with all the literature that shows how all of these things can promote healing, hospitals are not making meaningful changes in the way they deliver care. Their idea of providing a healing environment is to put pictures of waterfalls and flowers on the elevator doors so patients can see them when they are being wheeled around on their cart. While that is a nice idea, it does not really get to the root cause of the problem.

You might wonder why hospitals don’t do any of the things I suggested in my ideal holistic center for wellness. From my perspective, it all comes down to the two things that motivate hospitals: getting paid and getting sued. Even if the hospital’s customer experience department wanted to open up a healing patio or allow fresh air into the rooms, the hospital lawyers would quickly shut that down. What if someone trips on a patio stone? What if a bumble bee flies in the open window and stings a patient and they are allergic to bees? These are the types of conversations that stop anything creative or innovative from happening in the hospital.

Then there is the issue of payment. It would take more staff to transport all of the patients to and from the healing patio, and the insurance company isn’t going to pay for that. The same is true for the kitchen on every floor. It is much cheaper to have a central kitchen and use the lowest quality food possible to meet the minimum requirements. Hospitals are in business to make money, even the non-profit ones. And they are not going to do more than they are legally required to do.

It feels so strange to write a blog that has such a negative tone. It is not who I am, and it is not how I want to spend my energy. But today, I can’t help it. It’s just how I feel.

I wish my Dad wasn’t sick. I wish he didn’t feel like he was locked up in a prison for the last four days while he’s been in the hospital. I wish the healthcare system worked better for him, and for all of the other people who are sick. I wish I didn’t know so much about the healthcare system. I wish I could speak up and do something to change it, but I know that I can’t.

My Dad is being discharged tomorrow. When he gets home, he can put on his favorite pajamas. And I can make him a delicious healthy dinner. And then we will sit outside on the front porch swing, so he can feel the fresh air on his skin. 

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