richard[WINTERS]md

Bacon Bandages

Available at Archie McPhee.
They have steak too.

Pattern of Patient Interactions

The same physician.
The same patient.
The same quality of care.
The same amount of time spent with the patient.
But there is a difference.

Visit 1: The physician spends all of her time seeing the patient at the beginning of the patient's visit.
Visit 2: The physician spends all of her time seeing the patient at the end of the patient's visit.
Visit 3: The physician divides her time seeing the patient into three separate interactions during the patient's visit.

After which visit will the patient be happiest?

Tour de Hospital: Don't show your sweat.

I sometimes sweat at work.

Capped, masked and gowned procedures under hot lights.
A difficult negotiation with a consultant.
Hungry. Must eat.
All certain to make me sweat.

I'm a big cycling fan and an avid cyclist.
July is a great month. The month of the Tour de France.

It's 107F in Fresno and I ride at 2p.
I wear an undershirt and it greatly increases my cooling.
It seems counterintuitive, more clothes in hotter weather.
A good base layer wicks away the sweat and provides a larger surface area to evaporate.

I wear a base layer at work.
I may be sweating, but you wont see it.
No wet shirts.
I stay cool.

I wear the 2007 Craft Pro Cool Base Layer.
There are many good base layers made by other companies.

Smile and Handshake

Every time I walk into a room I make it a point to smile.
A gesture that shows happiness, humility, and a desire to please. I'm here to help.

This can be difficult.
I may have just pronounced a patient dead.
I may have just been insulted.
Perhaps the prior patient pointed out my crooked teeth.

If I'm not ready to smile, I wait.
I meet every patient with a smile...and a handshake.

To each person in the room, "Hi! I'm Dr. Winters."
Shake hands.

If they can't shake hands, I grasp their arm.
If they don't have arms, I grasp their shoulder.
If they don't have shoulders, they are likely very ill.

Patients don't come to the emergency department to be triaged.
They don't come to talk to registration.
They are not here to sit on gurneys in half open nightgowns.
They come to see the doctor.

Here I am.

A Better Patient Introduction

At the beginning of each Fresno State basketball game there is a moment of music. Dry ice blows smoke. House lights dim. Spotlights flash. The resonant voice of the announcer shouts "Yourrrr Fresno State Bulldogsss!!!" and the players burst onto the court. The crowd gets on their feet. Everyone cheers.

Why not bring this to the bedside?

Lights down. Dry ice fog. Loud thumping music. My scribe shouts "Yourrrrr Doctor Winterssss!!!" The curtains part. I chestbutt my scribe and give everyone in the room high fives.

Might be effective. Might be awkward. Might kill grandma.

Sports teams understand that the introduction sets the tone for the whole game. A great introduction announces energy and intent. It brings the home team players and crowd together.

I used to walk into a patient's room and say whatever came to mind. Sometimes this brought the patient and myself together, sometimes it was uncomfortable and ineffective.

I've worked to make my introductions more effective.

It is work to change old inefficient ways. However, it makes work more enjoyable.