Thursday, July 24, 2014

Human Centering: Enhancing Success in Health Care Situations

Presentation at The Institute of Holistic Leadership  with Pat Jonas, MD  July 24, 2014

Introductions: Megatrends, Avoiding "Non-Compliance"

Centering: Patient, Payment, Physician, Hypnotherapist, Health System, Public Health, Human

Human Centering:            What it is

                                             What it Does

                                             Why it’s important
Where and/ or when human centering may be beneficial?
How to do it:  Notice how you use your five senses.  Which one leads?
               Become Wholehearted by balancing the autonomic nervous system (“The Mommy Heart”)
P O L A R to another person in dialog  whole (sort of) wholehearted
Notice:   Assumptions, Context of them and you, Process of them and you
Human Centered Health Home (HCHH) Process for dyad
Holistic Strategies for Human Centering
               Mind-Body Therapies
               Body Work
               Energy Work (Overtones – one of the secrets)
How to use Human Centering
               In Health Care Engagement as patient/client or practitioner (working and caring)

               In HC System as visitor- e.g., in a hospital (working and caring)

               With a friend who has health problem

Human Centered Health Care (HC)2
               Context of dyad

               Process of R P C D C R

Heart to Heart Rapport
               Trance A to Trance B
               Rapport: Human to Human, Heart to Heart
               Dialog: Wilber’s Four Quadrants from A Brief History of Everything by Ken Wilber
               Human Connection: P O L A R to Explore, Understand and Act   P I E S x L L W
The Art of Health Care by Bill Anthony, The Art of Helping by Robert Carkhuff
The Structure of Magic Volumes I and II by Richard Bandler and John Grinder
Consulting with NLP by Lewis Walker
Hands of Light by Barbara Brennan, Wheels of Light by Rosalyn Bruyere for Quick Coherence Technique numerous blog posts: HCHH and process of care in Family Medicine

Tuesday, July 22, 2014

Non-Compliance Soon to be Top Diagnosis

Within three years, the top diagnosis in EMR's will be non-compliance with medical therapy or dietary therapy or exercise recommendation, etc.  (My opinion)  Patients and physicians are now trapped by the Electronic Medical Record.  The plan of care must include the recommended therapies for the diagnosis or the physician loses bonus potential.  There must be proof that the medicine was prescribed and the pharmacy dispensed it or the physician and/or the pharmacy may lose quality points or bonus dollars.  Just watch.

Information Technology tightens the system and decreases choice.  We used to be forgiving about patients that would sometimes decide not to fill prescriptions or sometimes decide not to take the medicine when they did fill the prescription.  Often, their judgement may have been better than ours as we came to realize.  Over time, we got to understand each others perspectives as our patient-physician relationship developed. Physician and patient learned how to honor each other's judgement.  The quality of the relationship depended on it.  IT initiatives now risk the patient-physician relationship, a central aspect in the quality of health care. The patient has to align with the "Patient Centered" decision of the EMR protocol that aligns with "quality".

Unless they want the diagnosis soon to be number one: Non-Compliance.

What's "Patient Centered" about that?

What do you think?

Thursday, July 10, 2014

Many Patients Assigned to New Doctors

Several of my current patients called my office this week on receipt of information assigning them to a new physician (not me).  They are insured via a medicaid managed care product such as Care Source, but two other companies won the Miami Valley area bid to provide medicaid managed care.  We are not a "participating provider" in either of the new plans, so our patients will be assigned by a computer to another doctor.  We'll lose 50-75 patients in this part of the healthcare transformation.  We have meaningful, ongoing relationships with our patients and these losses hurt on the personal side, too.

We'll have to replace those patients, many of whom I've cared for for 6- 15  years, with direct pay patients, who will not have interference by insurance companies or government intervention.  The business survival of thousands of independent Family Physicians is touch and go for the next couple years.  This is a  very rough time in health care for patients, too, as they lose insurance and get a different plan with a $3000- $5000 deductible that they can't afford.  Many can't pay their doctor bills with the higher deductible and eventually lose their physician again.  Duck.

More later.