Doc, Come Quick!

Besides reading about modern health care innovation, I love to read historical and fantasy fiction and watch historical dramas. One things I've noticed is this: health care skills have always been valued. I expect this will continue. 

Take the case of Claire Fraser, heroine of the Outlander series. She's a time travelling nurse who goes from World War II to 1743, and although she lands in hot water almost immediately, she is able to win the trust of her captors with her medical skills. Not only is she an amateur botanist, she knows about...germs! Which puts her ahead of her sudden contemporaries. She's got excellent diagnostic skills, having read and seen all manner of illness in her time. Ms. Fraser is experienced with sutures, tinctures and identifying whether a rash is a serious or fleeting illness. Her skills amaze others and she saves lives and wins the trust of many who help her find her way. (Of course, much of the delight of her skills for readers is that in 1743 everyone thinks she's a witch...but it's just modern medicine transported 200 years in the past!)  

Same with Doc Cochran, the only medical professional in Deadwood -- based on a true town in South Dakota. He's a grump Gus, and he should be because his patients are nearly all in bad shape. They've been injured in a mine, shot in a gunfight or are infected with a veneral disease. The show is all about this violent town's struggle for gold and independence, but Doc is able to disagree or raise a holler without any consequences...because everyone knows they soon may need his services. No matter how vicious relations get, the Doc is able to treat people, insist on better public conditions and even defy some of the more powerful people to do what he needs to do, because he has the medical skils that anyone may need imminently.  

I note these two characters, but there are many more, on apocalypse shows like The Walking Dead or CW's Hart of Dixie or BBC's Call the Midwife that make the same point. People will always be in need of health care, at some point. That makes these skills invaluable -- and I would like to note, we need to prioritize public first aid response training, professional health care education AND preventing burnout for our health care professionals, too. It's part of the human condition, and today we know that more than ever -- so we should be ensuring that we recognize this value. 

Infectious!

After giving a presentation this week on infectious diseases and deciphering health information, plus attending an excellent SHSMD session on the handling of the Ebola panic, I have a few thoughts. 

1. Even if all of us who work in the medical field think that people should know something, it's best to go back to the basics. Like the super-basic foundations of science -- for example, that a virus and a bacteria are different things but both can make us sick. Or, that one study does not science make!

2. Internal communication is ultra-important in a crisis. It's not enough to reassure the public. You must communicate to your staff, your board members, your volunteers and anyone working in your hospital. Because your credibility goes in the toilet when you say "We're prepared" but the reporter interviewing nurses on the loading dock hears "We've had no training on this."

3, Fear is a strong motivator, even if people know they shouldn't be afraid. They are, and they want to play it safe. I heard from someone who was thinking of firing her nanny because the nanny's mom was a nurse. It sounds like an overreaction now, but if you recall earlier this year, we were a nation on the edge of our seats as to whether we'd have an outbreak or not.

4. Communication takes time. It can be laborious when you want to be doing (let's go!!!) but it will save you time in the long run. Return people's calls (especially reporters!) even if you don't have anything new to share. Tell your employees what to expect. I agree with Doug Levy (formerly of Columbia University Health System) who said "Communication can't solve everything but it puts you in the best position to catch flaws in your plan." 

Infectious diseases are a tough topic, but one that we will continually revisit. They won't go away -- but we can educate and we can prepare. Oh, and we can communicate!