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also a retired nurse here what good is being the best if you cannot communicate with your patient .That is fifty per cent of rendering good patient care for optimal results.
good business depends on good service.there are drs out there that have excellent skills with their field and their clients
Just the facts and use of knowledge, down to business.
By the way, I'm not defending him one way or another but no one is in a hospital for a vacation.
People do think hospitals are customer service and on some surveys I hear they would complain about things like how the food wasn't flavored enough, how their lunch was overcooked and how the water pressure in the shower wasn't strong enough....
as a retired nursing supervisor I understand your points .there are many ways to handle belligerent uncooperative patients
some drs do get plus ratings for being pleasant and not for skill but the real jewel physician is skilled in his field and with patients
as to the shortage it is a combo of continual rising med school costs and malpractice insurance costs----and ineffective lobbying to lower both IMHO
We already are highly monitored by those surveys, but believe it or not being sugary-sweet is not always as important as saving your life. FYI, recording health care interactions is illegal due to HIPPA laws.
Someone needs to tell Beto .
(Or is it permissible if you have permission from the provider?)
Nurses are heavily scrutinized and often terminated or suspended for minor things. Whereas doctors are given free rein and can be absolutely horrible and yet practice until full retirement is taken. Few want to confront them or go through the myriad of steps needed to take them down.
We are monitored constantly by hospitals, patients, insurance. Several people already pointed to Press Ganey and HCAHSP scores. In addition insurance companies will provide patients with surveys, large clinics often do the same.
The reason this may not benefit people as much as a review of a restaurant or retail is we have to tell people things they don't want to hear. I have to tell people to stop eating junk, exercise, stop smoking, you cant do this, you cant do that, on and on and on. That grates people, especially if I am the 30th person to remind you of your BMI or your fast food habit. Honestly most upset patients just change docs.
Sometimes its as simple as a personality issue. Some like dry docs, some like a doc that can tell a joke. I have personally had patient's tell me I am great or stink compared to my partner just based on my personality difference alone. I know that because I don't change my partner's plan of care if covering a single visit so nothing changed in their care except me. And it goes both ways so I know its not just my charming personality.
Heroin is a very poor analgesic, as it has a very short pharmacodynamics effect and, as a result, is highly addictive. Thus, as an "analgesic" heroin has no value in clinical medicine. Your contention that "pure" heroin would be a "good" pain reliever, and is simply encumbered by unknown "additives" is simply absurd.
If Heroin was such a good analgesic, instead of being Schedule 1 (no therapeutic medical use), it would be widely used. Of course, it is not, except as a street drug.
It is used as a painkiller...morphine is basically heroin, there is a small change when heroin is cooked and it converts to '6MAM'. but its still basically the same thing.
Heroin was used to treat pain in the past too.(although not in the US).
It is used as a painkiller...morphine is basically heroin, there is a small change when heroin is cooked and it converts to '6MAM'. but its still basically the same thing.
Heroin was used to treat pain in the past too.(although not in the US).
Morphine and heroin are not the same thing- not by a long shot. To state otherwise is factually incorrect and academically disingenuous. Heroin is derived synthetically by the acetylation of morphine. Codeine and morphine, on the other hand, are chemically very close. Heroin, when absorbed in the body, is de-acetylated and forms morphine. Heroin was used in the 1800s as a means of morphine detox; however, it was rapidly recognized that heroin was far more addictive than morphine (due to higher lipid solubility and very short pharmacodynamic effect) and was banned in the UK in the late 1800s altogether.
Heroin is not used anywhere in the world today as an analgesic for obvious reasons.
Very rapidly absorbed drugs with short pharmacodynamic effect (different than pharmacologic half life) are very addictive and thus have very limited practical use.
I am a physician who deals with narcotics everyday. There are obvious reasons why the public, lacking training and education in pharmacology, are not charged with choosing their own analgesics, otherwise we would have disasterous consequences.
As a former heroin addict, you, more than anyone, understands how dangerous and life threatening heroin can be. Given your experience, it is shocking that you would be espousing the virtues of heroin. If it is such a wonderful drug, why did you ever get off it?
I have always wondered why in hospitals doctors and nurses customer service skills aren't monitored or recorded for quality assurance purposes.
The hospitals I worked in were certainly concerned with customer-service skills & they didn't mind sacrificing the health of their patients to prove it.
"Find ways to say YES!" was the slogan & subject of far too many in-services. Unfortunately; the leading causes of death here in the US can be directly linked to lifestyles where people; "said YES" ... far too many times:
"Yes; I want another smoke, drink, toke, hot fudge sundae, double cheeseburger & fries, pass the salt & yes; I'd prefer to sit here until I beat the next level. And the next level. And the next ..."
Compared to me; Nurse Buzzkill:
"No, you have had enough narcotics to kill a cow; I can't give you anymore but I am going to call your doctor; as it is concerning that you are still having 10/10 pain."
"No, we can't let you keep that 2 liters of soda your family sneaked into you; your blood sugars have been over 300 since you were admitted. If you don't like the beverages on our diabetic diet options, I can leave a note for the diabetes educator to come to see you. Maybe they have some suggestions?"
"No, I can't bring you some water; your doctor ordered that you have nothing by mouth for 6 hours before surgery, otherwise you are at risk for aspiration, pneumonia & death. I will be starting an IV for fluids & that will help your thirst some."
See, the bolded above represents the extent of customer service I can afford you. And it's weak, I know but many patients are already upset & don't even hear the bolded & then the nurses are labeled as "rude".
Why aren't nurses and doctors customer service skills monitored and audited like call-center workers.
I am a former Family Practice clinic worker
In some ways we were monitored just like a call center always looking for a way to get more customers in and increase productivity.
30 minute appointments --no way, 20 minute appointments --getting better, 15 minute appointments AND lets schedule 5 per hour because statistically one will be a no show!!!
Morphine and heroin are not the same thing- not by a long shot. To state otherwise is factually incorrect and academically disingenuous. Heroin is derived synthetically by the acetylation of morphine. Codeine and morphine, on the other hand, are chemically very close. Heroin, when absorbed in the body, is de-acetylated and forms morphine. Heroin was used in the 1800s as a means of morphine detox; however, it was rapidly recognized that heroin was far more addictive than morphine (due to higher lipid solubility and very short pharmacodynamic effect) and was banned in the UK in the late 1800s altogether.
Heroin is not used anywhere in the world today as an analgesic for obvious reasons.
Very rapidly absorbed drugs with short pharmacodynamic effect (different than pharmacologic half life) are very addictive and thus have very limited practical use.
I am a physician who deals with narcotics everyday. There are obvious reasons why the public, lacking training and education in pharmacology, are not charged with choosing their own analgesics, otherwise we would have disasterous consequences.
As a former heroin addict, you, more than anyone, understands how dangerous and life threatening heroin can be. Given your experience, it is shocking that you would be espousing the virtues of heroin. If it is such a wonderful drug, why did you ever get off it?
I believe heroin should be legalized and REGULATED, this is most effective way to 1.) remove the criminal element and 2.) for harm reduction.
An addict that is abusing Percocet or Opana is 'safer' than an addict abusing street heroin, since it is illegal, the users cannot be sure what is in the drug they are buying and using. dealers typically add other drugs to increase weight of heroin (to make more money), at least with the pharma supplied pills, they know what they are getting and taking.
I support safe injection sites, where addicts are provided with pharmaceutical grade heroin, and the gear needed to use it.
Personally, I have no desire to use heroin anymore, Suboxone saved my life, I have been on it for about 3 years now, and I will likely be taking it the rest of my life. Its been a miracle drug for me, but I realize its not effective for everyone. There are patients at my office who try to use along with the suboxone or abuse the Suboxone.
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