Shawn Whatley, Author at shawn whatley md

Put Patients First – What Does It Mean & How Can We Do It?

“Then you should say what you mean,” the March Hare went on.   

“I do,” Alice hastily replied; “at least–at least I mean what I say–that’s the same thing, you know.”   

“Not the same thing a bit!” said the Hatter. “You might just as well say that “I see what I eat” is the same thing as “I eat what I see”!”

Great healthcare systems put patients first; patients hold top priority. How we view patients impacts treatment. What then does “put patients first” mean?

Do we envision product placement, like ‘put magazines in front of customers’?
Or do we mean a ceremonial nod to a notion that germinated Medicare?
Or do we mean something like, “Go Blue Jays!”?

Individuals versus Herds

A system cannot put patients first. A health care system cannot function by considering patients as individuals. To design a service that cares for 11 million people, we ignore individuals and focus on herds. We step away from the bedside and envision patients as discrete atomic units or numbers.

Furthermore, systems are impersonal. Only people put patients first. Systems grow out of complex relationships between organizations, providers, suppliers, regulatory authorities, governments and a crowd of others. Systems cannot put patients first without intent and effort.

Medicine is ineradicably individualistic. The doctor-patient relationship defines medicine. Unless a healthcare system intentionally measures its policies by whether or not it puts patients first, patients will get treated as members of a herd.

Put Patients First

It means we assign or attribute value to patients above innovation, budgets, quality, regulation, efficiency or any other important issue that systems tackle. Patients must be seen as individuals with unique perspectives, genetic make-up and experience of disease and health; as units of social groups, communities and families; as members of society with complex roles to play in other patients’ lives.

It relates to how we consider patients when we think about healthcare systems and design. It implies that our thoughts about process and efficiency place patients’ needs and unique expectations before system policy, budgets and regulatory restraints.

A vision for healthcare must start by adopting an intentional, arbitrary standard of putting patients first. ‘Intentional’ because systems can function efficiently without considering patients. ‘Arbitrary’ because systems can choose to not put patients first. Next time we see heads nodding when you talk about putting patients first, make sure we say what we mean.

A Vision For Healthcare

Health minister Rona Ambrose announced a panel to look at improving the quality and efficiency of healthcare.

What would you suggest if you sat on the panel? What features do you consider essential to a great healthcare system?

If asked, I would offer the following list of concepts, ideas and axioms. Most apply to all healthcare systems – public, private, hybrid, etc. Most are funding agnostic and need consideration whether we use taxes, insurance or out-of-pocket dollars. Many points in the list already feature in Canadian Medicare.

Patient service can suffer in any healthcare system regardless of funding and design. We cannot assume some issues disappear simply by legislating a particular system.

One comment for my libertarian and small-government readers. Before you spit out your coffee at this list, I think we must acknowledge that no system will ever be 100% market based just like no socialist system can operate without some element of profit (e.g., using medications developed by industry). We need to make business oriented approaches as compassionate as possible, and statist approaches as customer-focussed and accountable as possible.

Books, lectures and conversations impacted the ideas. Please add more by sharing your comments!

A Vision for Healthcare –

110 Ideas

To incorporate feedback, I put a Vision for Healthcare on its own page. Please share your thoughts on this post and any other and I’m improve the content as you share. Thanks so much!

Writing Process Blog Tour

Lara Whatley invited me to share about my writing for the Writing Process Blog Tour. Thanks Lara!

Lara’s first book, The Last Pages, released last week, but she hasn’t basked in the glow yet. She’s editing her sequel for submission before starting CEO leadership program at Muskoka Woods next week. Lara, you rock!

Writing Process

What am I currently working on?

I keep four baskets of writing ideas in mind: blog, popular media, journal articles, and books. While life conspires against producing content, I can usually get 2-3 short posts out per week. I’d like to be more intentional about setting goals for each basket.

I have almost completed a small book on patient flow in emergency medicine. It outlines the approach our team took to make us #1 in the Ontario for the last few years.

How does my work differ from others of its genre?

Very few write about medical politics from the inside. It’s too dangerous. People working outside healthcare can offer pointed criticism without worrying about their jobs. But if you work inside the system and help lead it, you must think hard about core issue you would die for.

Why do I write what I do?

Patient benefit. I wish more people working inside the system would write about how Medicare puts providers before patients. Provider are important, but not the focus of healthcare. We need to put patients first, not budgets or process or unions or contracts or anything else.

I believe writing changes the way people think.

How does my writing process work?

It starts with a good idea. Since good ideas are easy to miss, I keep notebooks in Evernote for each type of writing.

Some ideas stand without support, but most require links, references, etc. I often start building an idea by finding out what others have said about it already.

Support drives argument. I use what others say to support my perspective or argue against others in support of the idea I’m presenting.

I try to end with a call to action. Sometimes this is easy, but most of the times I struggle with it. Since I get most excited about ideas, my ‘call to action’ usually means encouraging people to think differently, which doesn’t pack the same interest as “Now look for 2 snacks to avoid purchasing today.”

Next blogs

My links for writing process are Gail Beck (drgailbeck.com), a member of the Order of Ontario with a CV too long to abbreviate, and Raj Waghmare, author, blogger (TheOverheadPage) , guitarist, Dad and power forward. They are MD writers with very different stories. I look forward to hearing about their writing process!