Monday, April 18, 2016

"Why (not) me?" Why doctors do it differently......

by Michael D. Fratkin MD

I am preparing for a presentation named in memory of a man I never met, Thomas Chippendale, MD. The organizer gave me some basics…well respected brain scientist and neurologist at Scripps and pioneer in the area of mindfulness with his wife, Julie Lawrence ChippendaleWanting more material on his personhood, I reached out to Julie. In the hour video-call, she painted a picture of a man that embodied kindness and purpose with every breath he took and in all the choices he made in relationship to his illness and approaching death. Choosing substantially less cancer-directed treatment and much more intentional life-affirming person-centered experiences than the average, Tom’s path reminded me of Ken Murray’s essay, “How Doctor’s Die.”

In that essay, Dr. Murray outlines his observation that while doctors working within a fragmented, high paced, and extremely expensive medical service delivery system will facilitate aggressive and high cost : low value interventions for their patients, they tend to choose home-based care focused on well being and the well being of those they love when they are sick.

According to a Stanford study led by VJ Periyakoil, “Most physicians would choose a do-not-resuscitate or “no code” status for themselves when they are terminally ill, yet they tend to pursue aggressive, life-prolonging treatment for patients facing the same prognosis..” In this study, almost 90% of surveyed physicians, presumably healthy, would forego resuscitation efforts for themselves.

In our next #hpm chat, on Wednesday, April 20th, 2016, let’s unpack this head-scratching situation together--not just for doctors, but for all of us…nurses, social workers, chaplains, program folks… that have reason to think differently about the nature of modern dying and our desired intensity of medical treatment.

  • Topic 1: What do you think about those of us in healthcare, with knowledge about the limitations of modern medicine, choosing less of it?  
  • Topic 2: What is your belief and / or perspective on our healthcare system often inflicting harm rather than delivering value?
  • Topic 3: What explains the disconnect between what healthcare practitioners know & what the public expects? How might we bridge that divide? 
  • Topic 4: How does your belief about the success or failures of the healthcare system influence your practice?  

Michael D. Fratkin, MD @MichaelDFratkin is a Father, Husband, and Palliative Care physician pioneering from far Northern California with soulful technology enabled person centered care in the home. With an incredible team, he is building ResolutionCare and changing the rules as he goes.

What: #hpm chat on Twitter
When: Wed 4/20/2015 - 9p ET/ 6p PT
Host: Michael D. Fratkin MD Follow @ResolutionCare

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