Morton, Plant, Mease Health Care

On Monday, December 8, I was the honored speaker for the nurse managers of Morton, Plant, Mease Health Care at Morton-Plant Hospital in Clearwater, FL. Always exciting to share my message, but double that excitement to work with nurse managers who can carry that learning back to their floor nurses!

Special thanks to Robin Lapham for helping arrange the event and for being such a thorough client! Always makes my job easier when my clients are on top of their game as you are, Robin! Thanks!

Bacchus in Columbus!

Sorry for the lack of postings the last week or so. I've been on the road a lot and now, here's why!

Thursday, Fri. and Sat. of last week, I was exhibiting and presenting at the Bacchus Network General Assembly held in Columbus, OH. This is the third year I've attended G.A. and I'm always so excited to get to meet new friends and see past acquaintances!

This year, I was also excited to present with the PACE team from DeSales University on "Booze Busters." To the best of our knowledge, this is the first time a university has partnered with a professional speaker to present a breakout session at G.A. I want to thank the PACE team for welcoming me in with open arms and congratulations on a job well done! Special thanks to Dr. Gregg Amore and Wendy Krisak for helping facilitate everything... and for one of the funnest times I've ever had at a conference dinner!

Side note: Friday night at G.A., there was a fire in a neighboring building. A big, stinky electrical fire. This fire caused the power grid to be switched off and hence, our hotel to be without power for nearly 12 hours. And yet? Hanging out on the street corner with the DeSales PACE team was just super fun! No one I'd rather be homeless with! And thanks to the Columbus Hyatt for handling the disaster in such a professional manner-truly one of the finer examples of customer service I've ever experienced!

"Your Prescriber"

I just watched a commercial for a prescription medication. Instead of saying, "Ask your doctor about XYZ medication..." they instead used the term "prescriber."

I like this... and I don't like this.

First, I like it because not all of the health care professionals I see are docs. Some are P.A.s, some are NPs, and some ARE physicians. My G.P. happens to be a family doctor, but the health care pro I see the most often is a P.A. All of these have the ability to prescribe drugs.

However, it's a constant criticism of the health care world that, all too often, medications are overprescribed. Patients, for whatever reason, don't feel as though they're getting quality care if they don't exit the practice without a prescription. A nearby walk in clinic actually advertises, "$50 for an office visit and prescription."

Well what if the person doesn't need a prescription? Is one given any way?

I like that prescribers are being treated equally (by advertisements, at least), but hate there's a continuation of prescribing medications as treatment – no matter what.

True patient care comes from the health care professional. Not from the drugs, not from the treatment of the ailment, but in the way patients are treated by their prescriber (and sometimes by the prescriber's support staff).
The human element should never, ever be replaced by a pill.

Hospital Workers Axed for Snapping Photos of Patients

Props to the UNM hospital for such swift and decisive action. Even if the patients in the photos cannot be identified, just to know one's arm, leg, torso, etc. is in a pic unknowingly posted to someone's MySpace profile is just disturbing.

Sadly enough, this incident, even if isolated, gives a bad impression of the hospital. Given a choice, will patients want to be treated at a hospital with this history? Maybe, maybe not-but by the hospital taking immediate action, it lessens the chances of this type of occurrence happening again.
*****
Hospital Workers Axed for Snapping Photos of Patients, Uploading to MySpace

Monday, September 22, 2008
ALBUQUERQUE, N.M. — Two University of New Mexico Hospital employees have been fired for using their cell phone cameras to take photos of patients receiving treatment and then posting the images to a social networking Web site.

Director of Public Affairs Sam Giammo said Sunday the photos — mainly close-ups of injuries being treated in the Albuquerque hospital's emergency room over the past few months — were posted on an employee's private MySpace page.

Giammo said he's never heard of a similar incident at the University of New Mexico Hospital or any other hospital.

A few other hospital employees were disciplined and the investigation is ongoing, he said.
UNMH values patient privacy "very, very highly and we will do everything we can to protect them," Giammo said. "We just won't tolerate unprofessional actions by any of our staff. We just won't stand for that."

The photos were discovered after a hospital supervisor received an anonymous tip about them Tuesday and launched an investigation.

Hospital managers personally oversaw the removal of the photos from the Web site and from the employees' cell phones, Giammo said.

"We have to rely on the people telling us that they don't have any others," he said.
The patients in the photos could not be notified that their pictures had been taken because their faces and personal identifying features had been removed from the photos, Giammo said.
Giammo said the MySpace page could only be accessed by the employee's online friends, not the general public.

Giammo said the employees who were fired violated a hospital policy that bans the use of cell phone cameras in patient areas. The other employees were disciplined for not bringing the photos to the attention of managers, he said.
The hospital is treating the matter as an employment issue and law enforcement has not been involved, Giammo said.

The use of cell phone cameras in hospitals have caused breaches of patient privacy or concern about such violations in California, Arizona and South Dakota in recent years.

"Florida Society of Medical Assistants"

Thanks to the FSMA for the opportunity to present at the state conference on Sat., Sept. 20!

Thank all of you for being such a warm and receptive audience AND for your commitment to excellence in customer service AND patient care.

Special thanks to Mary Morris for being such a great client and helping arrange the event!

Teleconference Network Of Texas

University of Texas Health Science Center at San Antonio

Yesterday was a first for yours truly. I was the guest presenter for a teleconference arranged by the Teleconference Network of Texas out of UT Health Science Center in San Antonio. We had a group of nutritionists from across the country hooked into the bridge and, based on some of the feedback via E mail, it went well! For the guy who’s real interactive with the audience, giving a program without human feedback was a challenge, but it went really well!

Special thanks to B.J. Brown in San Antonio for being such a great host and moderator! I’d include some pictures, but since this was over the phone, you don’t really want to see me sitting on my couch in a grubby old tee shirt and khaki shorts, do ya?!

Three Things To Remember Every Time You Meet A Patient

Today, I had an appointment with a pulmonologist who specializes in sleep disorders. Turns out, he’s a fantastically nice physician AND he has a great staff!

After only a few minutes in the waiting room, we were led to the exam room. This is where it gets good!

The nurse comes in with a big smile on her face (that’s thing #1). “I’m Anna. Can I get your vitals?” (that’s #2 and #3)

Smile. Something so easy, totally free and has so, so much power! Plus, any time a patient sees a new physician, chances are, there’s going to be a little nervousness. Anna’s smile put me at ease. It indicates that if she’s happy, then her working conditions are good and she works for a good boss. Can’t say that across the board, but there’s something in that sub-consciously which made me know the doctor would also be a good guy.

Second, she introduced herself. Who wants to be touched by someone they don’t know? No one! But as soon as Anna told me her name, we had a connection. Simple as that, I felt like she was making a human connection, not just doing her tasks which happened to involve my body.

Third, she asked. In my state, if I touch anyone without his/her permission, it’s considered battery. When Anna introduced herself, it eased my worry and that eased my defensiveness. When she was considerate and asked for my vitals, I was all too happy to oblige!

Just three things, but remembering this trifecta is certain to help your patients see you as a true pro!

"Is Your Doctor Laughing at You?"

Interesting study. And doesn't it show how docs, just like the rest of us, know what is right, but sometimes still choose wrong?
- Marcus

By Theresa Tamkins.
Provided by Health.com Y
ou’re sick, in the hospital, or maybe even undergoing surgery. The last thing you want to contemplate is the thought that your doctor might be making fun of your tattoos while you’re anesthetized.But does it happen? Yes.
According to a survey of doctors starting a residency in internal medicine, 17% had—along with their colleagues—made fun of a patient, sometimes when the patient was under.

Egad. Is nothing sacred? The good news, though, is that 94% of the 110 medical interns who took the anonymous survey realized that such behavior was inappropriate, according to a research letter published in the Journal of the American Medical Association.

That means that only seven doctors in the survey thought that type of behavior was A-OK.

I guess it’s not that surprising, given the behavior of our on-air favorites. From Grey’s Anatomy to House, the overwhelming warts-and-all portrait seems to be this: Doctors are human. They fall in love, they get angry, and they like a good chuckle—sometimes at the patient’s expense.
Is it so surprising that some of those bad on-air behaviors might occur in real life too?
Is unprofessional behavior more common than in the past?Television shows from yesteryear, such as Marcus Welby, M.D., and Dr. Kildare, presented doctors as somber and ultraprofessional, but that doesn’t mean that unprofessional behavior is a new problem, says study author Vineet Arora, MD, an assistant dean at the Pritzker School of Medicine at the University of Chicago.“Those shows projected a much more professional image,” she tells me, but “to say that this is a new phenomenon would not be correct.”

Learning respect and discretion are part of the so-called hidden curriculum—all of the things doctors learn on-the-job that don’t have to do with diagnosing and treating diseases.
Hospitals want to make sure that more seasoned doctors don’t promote or perpetuate unprofessional behavior and that newly minted MDs—like those surveyed—learn what is appropriate and inappropriate by the time they finish their residency, the training period after medical school. While the teaching hospitals aren’t trying to drain all the humor out of the residency experience, they want to teach doctors where to draw the line. “I do think there are examples of really good-natured humor that is therapeutic, but not at someone’s expense,” she says.

And laughter at a patient’s expense could compromise care, says Dr. Arora. “What if you were a patient and someone made fun of you behind your back?” she says. “You trust somebody to care for you and you would wonder about their ability to be objective and truly care for you.” Dr.

Arora couldn’t say whether the behavior of TV doctors -- such as Dr. House -- influences real-life doctors in any way. “That’s an interesting question,” she says. But TV programs do influence the public’s image of doctors.“Certainly media portrayal of physicians definitely has an impact on the public perception of physicians,” she says.Burnout may contribute to unprofessional behavior Dr. Arora suspects that sleep deprivation and burnout are part of the problem. Doctors who behave unprofessionally, she explains, might have troubles of their own. “There’s a lot of good data to suggest that people who are sleep-deprived in these settings do have more staff conflicts and burnouts and could possibly even further exacerbate unprofessional behavior,” she says.And there are more serious behavioral problems—aside from laughing at patients.

The survey included questions about behavior that is frowned upon, such as attending a pharmaceutical-sponsored dinner or social event (69%), as well as behaviors that are considered egregious, including falsifying patient records (13%), and reporting patient test results as “normal” when unsure of the true results (10%). “Those are examples that would compromise patient safety,” Dr. Arora says.An unprofessional demeanor in residency could spell trouble for your entire career, she adds. Research has shown that those with poor ratings on professional behavior early in their careers are at greater risk of disciplinary action later on.

Florida Civitan Convention

Thanks to the Florida Civitan Convention for inviting me to keynote on Saturday, Sept. 13!

Civitan (if you're not familiar), is a civic organization with a strong emphasis in providing assistance to individuals with developmental disabilities. And a more quality group you cannot find! Business, civic and faith-based leaders all compose this organization with a really special mission!

Thanks to Jean Smith, the Florida Civitan Governor, and also to Dr. David Persky for promoting my services to yet another group! Pics include me with Abigail Persky (Dr. Persky's daughter and one of my coolest friends from Academy at the Lakes).

B o d y G u a r d

The nurse enters my room. It’s the hourly check up on my vitals, wound dressings, pin care for the external fixator and, of course, taking a peek at the dreaded Foley. This is typically uncomfortable enough, but this time my parents and a few of my high school buds are here for a visit. I am working hard to remind these people I’m still “me” despite the horrible injuries, so these normal, but still invasive procedures are working against me. Not only do I want to refuse the usual care at this moment, but lifting my robe to show the nurse the catheter is beyond humiliating. Granted, I shared the locker room with these guys just months ago when we were all playing varsity football together, but no one wants to be exposed, much less when there are tubes and tape everywhere. The audience just makes this so much more dehumanizing.

My friends are all seated to the left of my hospital bed. The right side, however, is as wide open as the plains of Texas. Yet, the nurse comes around the foot of my bed to position herself on the left. Her back is to my family and blocks their view of me from the abdomen to the thighs.

“Can I borrow one of these?” she asks, giving a quick tug on one of the unused pillows scattered around my bed. When I answer in the affirmative, she takes the pillow and lays it on its side at the edge of the bed, adjacent to her body. The pillow now acts as a makeshift privacy curtain. Between her body and the pillow, everyone is spared the embarrassment of exposing my body – especially me. And my family and friends aren’t forced to leave the room. The nurse has just gained a HUGE amount of respect from her injured patient for helping me retain some degree of dignity.

Vanity is so often lost in a hospital. People who are adamant about showering and shaving every day don’t have that luxury while they’re a patient. Designer clothes are traded for ugly hospital gowns. Hair gel? Moisturizer? Perfume? Not in the hospital!

Yet, these differences between the hospital and the outside world are usually tolerable. Being forced to expose oneself is totally, TOTALLY out of the ordinary. It’s not so bad when the exposure is to a health care professional, but in front of family and friends? Could anything be more humiliating – especially for a teenager?

My nurse knew this. She used what she had; her own body, a pillow and, now that I think of it, the bedside table, too. These all formed a protective visual guard between my nudity and my visitors. That way, the nurse could still “get ‘er done” while helping me retain privacy AND not inconveniencing my friends.

When treating the “embarrassing” areas, you may need to practice some ingenuity. What do you have that can protect your patient’s dignity and privacy? Your body? Pillows? Blankets? – anything that can be a blockade between the visitor’s eyes and the patient’s body. Or maybe distract the visitors by pointing at something out the window or asking about something they just aired on the TV. Don’t forget to get your patients input on when the best time to ask visitors to leave. It’s perfect to play the “bad guy” to protect the patient’s wishes and dignity.

Whatever you can do to help guard the privacy of your patient will, in turn, help that patient feel more like a person and less like a patient. And in that way – everyone wins.

Better to Be Safe Than Sorry

How to Avoid Errors in Surgery
By Elizabeth Cohen,
CNN
filed under: Health News

ATLANTA, Georgia (CNN) -- I thought my husband was crazy.

When our 2-year-old daughter had hernia surgery, he insisted on seeing the surgeon minutes before to remind him that the hernia was on her right side, not her left.

The nurses weren't happy; it wasn't protocol to have the surgeon meet with parents immediately before a procedure.

"Maybe this is overkill," I said to my husband. "He knows what side the hernia's on. He's already seen her twice in his office. Plus, we've told the pre-op nurses 10 times it's on the right side."

But experts tell me my husband was right on. Mistakes do happen, no matter how great the surgeon, and it behooves you to help them get it right. Witness these headlines: Minnesota doctors remove the healthy kidney of a cancer patient while leaving the diseased one behind; California doctors remove the appendix of the wrong patient; one of the most experienced surgeons in a Boston, Massachusetts, hospital operates on the wrong side of a patient. All of these mistakes happened in the past year.

Solid numbers are hard to come by, because most states don't require doctors to report surgical errors. To make sure you're not the next victim, you might have to get pushy, like my husband did.

"You need to be that thorn in their side," said Dr. Samuel Seiden, an anesthesiologist who's co-author of a study on surgical errors. "You will catch things. You might also frustrate the nurses, but you have to look out for yourself."

Of course, looking out for yourself can be tough when you're anesthetized. But Seiden and other surgical errors experts say there are steps you can take to lower the chances you'll become the next headline.

1. Check out your doctor and hospital
Specifically, ask your doctor how many times he or she has done this procedure, and compare that with other physicians.

You can check out the hospital by going to HealthGrades or The Leapfrog Group, which rank hospitals by specialty. (For example, you can find good places to get hip surgery in Topeka, Kansas, or to have a baby in New York.) The U.S. Department of Health and Human Services has detailed information about procedures performed at different hospitals.

2. Tell everyone who you are and why you're having surgery.
You may feel like an idiot, but tell all the nurses and doctors your name, your date of birth, and what surgery you're having (for example, "I'm John Smith, I was born 10/21/70, and I'm having arthroscopic surgery on my left knee."). This can help prevent you receiving a surgery intended for someone down the hall. (Of course, if your name really is John Smith, you might want to give your address, too).

3. Make sure your doctor initials your site
The American Academy of Orthopaedic Surgeons urges its members to sign their initials directly on the site before surgery (shown in the group's public service ads, like the one pictured above). Make sure your surgeon -- not somebody else -- does the signing and that it's in the right place.

4. Confirm the surgery site with the surgeon right before the procedure
You may have already told the nurses, but it's the surgeon who's doing the actual cutting, so you need to tell him or her directly, says Dr. James Beaty, past president of the American Academy of Orthopaedic Surgeons.

"You should say, 'I'm not going back to surgery until I see my doctor and we confirm that this is the right site,' " he said.

5. Train someone to be your advocate
Don't just bring a friend or family member to your surgery; train them to advocate for you. You're likely to be anxious and a little addled before the surgery (not to mention asleep during it), so you'll need help.

"Equip them with the information they need," advised Ilene Corina, president of PULSE of New York, a patient advocacy group. For example, your advocate can help you check the initials on the surgical site or help you contact your surgeon.

So, how did my husband know to follow Tip No. 4, before he had the chance to read his lovely wife's column? He says it was just common sense -- and his submarine training. When you give an order in a submarine, the other person repeats it back to you, and then you repeat the order again. In engineering lingo, it's called creating a "closed loop."

Our daughter had a successful surgery, and I'm sure the surgeon would have gotten the correct side even without our involvement. Still, it can't hurt to check.

After checking, as they were wheeling our precious baby into surgery, my husband looked the surgeon in the eye, put his hand on his arm and said, "I know you've done this hundreds of times. But for us, she's our only one."

I'm sure that didn't hurt, either.

To watch the video, go to cnn.com.

What the Doctor Thinks...

There's an article on foxnews.com called "What your doctor is thinking (but would never tell you)"

FOXNews.com - What Your Doctor's Thinking (But Would Never Tell You) - Health News Current Health News Medical News

Ya know, we patients do plenty of complaining about the health care providers we see. Some of it's deserved, some of it is just human nature to complain.

This gives some insight to a doctor's thinking and the challenges he/she faces in their work. I work with health care providers and professionals quite often, but I've never put some of these things together. Like, I've been through unnecessary tests. My initial thought is, "The doc is doing this to earn more money from me and my insurance." Yet, due to lawsuits, one of these docs says he orders unnecessary tests because he simply cannot let anything slip through the cracks for fear of being sued.

So many in the public need the good talking to that some docs want to give. Really, who can blame the docs for their frustration? See a patient two or three times per year for Type 2 diabetes and yet they keep gaining weight? That's gotta make the average doc want to pull his hair out! And how do you bridge that conflict with the patient?

Most doctors, as the article says, take the path of least resistance-tell the patient something kind, supportive and helpful...knowing full well the next time they're in, it'll probably be worse, not better.

What are we to learn from this article? First, that docs are people, too. Second, that patients (yes, us) need to take more responsibility for ourselves. Third, a bit of compassion for the physician who is doing the best he/she can.

(http://www.foxnews.com/story/0,2933,388822,00.html)

The Best...

Best of CraigsList posting I read this "Best Of CL" post and, if you're anything like me, you'll be wiping away tears at the end. To all health care professionals-Tim here isn't the only one who is eternally grateful. We all are. Every single one of us who has been touched by trauma, everyone who's been afraid and hurting-all of us. And to all the docs, nurses and other health care pros-this is what ALL health care pros need to strive for. To be compassionate, to be a comfort, to provide excellent patient care, no matter who the patient is. Tim, I tip my hat to you for the shouts you give to your caregivers...

---------------
I Really Need To Thank These Strangers

Ok, so people often ask, where are the good kind people anymore?

Driving on Mt.Rose Hwy, and serving our communties is where! So I'm coming home to Reno on my motorcycle Saturday Evening after a short ride up to the
top and back down cuz it was too smokey up there, somewhere around 8pm I think? Anyways... Near the bottom, I hit some oil, gravel, not sure what... but
even as an experienced rider for some 30+ years, made my bike wobble so bad, I eventually lost control after doing everything I could try to do to keep
it up. From what I hear, might have even hit a guard rail at some point during the crash, no memory so not sure, all I do know is next thing I'm on the
pavement in a ton of pain. Rolling in the road I think...

Stranger #1 -
Then, there was a hand... holding mine, comforting me thru my gloves... Kept hearing a voice that I think was female telling me "everything was gonna be
ok" and "help is on the way". Couldn't really open my eyes much, that's why I'm not sure if it was male or female, but it didn't really matter at that
point, ya know? I just know 'till the day I die, I will forever remember how comforting it felt to know that "if" I was gonna die then, someone was gonna
be holding my hand while it happened and I would not die alone on some road tasting asphalt.

You have no idea what that meant to me, still does, and always will. You probably also have no idea how much gratitude I would like to express to you for
the comfort you gave me, a complete stranger, when I really, REALLY needed it. I just remember your hand, rubbing mine and your soft, kind, compassionate
words letting me know, someone cared. You didn't just drive by, you took time out of your Holiday weekend to help me - some fat ass biker guy that some
here on CL wish we would all crash and die.

Stranger #2
No clue who this was either, but someone called police/ambulance, etc. super quick and there they were, hot on the spot within minutes. (felt like minutes
to me anyways, damn quick!), can't thank you enough and damn glad ya had signal...hahaha!

Stranger #3
Again, same as the others, no idea who you were, but I heard someone else say something I think about removing my helmet. In my mind I was thinking please,
please don't do that, but I couldn't say it. But you could and did, you spoke up and advised against it. Damn I am glad there are people like you who know
better and again, my sincere appreciation and grattitude to you as well.

Strangers #4, 5, 6, 7, 8, etc..
To all the police firemen/women, ambulance drivers, person in the back of the ambulance.. to all of you emergency responder type people who showed up who
did whatever it was you had been trained to do, and loaded me on some kind of back board or something I think, and then put my big ol' self in the ambulance
and got me to Renown so quickly - my most humble thanks and appreciation as well. I know you were "just doing your jobs", but damn you do them well! You
will NEVER hear me bitch about your pay raises or what it costs for the absolute QUALITY services you provide our community! I do know of one policeman
or hwy patrolmen who I think arranged to have my bike towed and visited me in the ER letting me know it's condition and where it had been towed to, cuz
he put his badge number on my insurance paper, as I get better in the next few days I would like to find you and thank you in person since I have a clue
on maybe how to find you from the badge #. You also gathered my personal belongings I had on the bike that would have been stolen for sure. (cam corder,
etc..) Yes, I know, small things to worry about in that moment, but you made sure I didn't have to, again, thank you for going out of your way for my needs.

To all the Dr.s, Nurses, and whoever else was working in that ER room, my eternal thanks and grattitude as well. Man I was hurting, them ribs are a bitch
when smashed, but you folks all again, did what you were trained to do in the finest proffesional manner (even on the embarssing stuff) and I just knew
from all your demeanors, I was gonna be ok.

I am sure there are some typos and mis-spellings in this post, forgive me as i am on some pretty strong pills for pain, but i just got to my computer and
wanted to get these thank yous out as soon as possible. All of you people just really have no clue what your kindness and compassion meant, and means to
me even now.I would like to let you all know, that from your kindess, skills and so on... I'm going to be ok. Could have been a lot worse, but thanks to
good people like you, a damn fine helmet and a little luck, both I and the bike are fixable.

If there is any chance of any of you "unknowns" letting me know who you are, I would greatly like to thank you all in person, if that's not your style,
I respect that and just know you meant alot to one hurting, scared guy, yeah... I was scared I'll admitt to it no problem!

Last and not forgotten in any way, once I was admitted to the 3rd floor, all the Nurses, CNA's, Orderlies, people waking me up every few hours to check
my vitals and stuff, I also sincerely thank you, but since I know how to re-find you all, i will be seeing you again in person to thank you properly, especially
Melissa, a nurse or CNA not sure, but one awesome lady I did not have enough time to thank properly today as I left! I really wish I could have stayed
and healed longer as today really ended up hurting, but you know why I had to leave. You friggin ROCK!

Sincerely,

"Citizen Service"

My Uncle Steve has recently had three run-ins with EMS. Nothing life threatening (thank God), but with his current health condition of liver failure, he's terribly weak. Two weeks ago, he sat on the edge of the bed, lost his balance and slipped to the floor. My aunt was unable to lift him to get him back in bed, so they called 911. Five minutes later and without the unnecessary spectacle of lights and sirens, the ambulance arrived. The paramedics lifted Steve back to a sitting position, swung his legs into bed and bid my aunt and uncle a good day. When my aunt asked what she owed them, the ambulance driver simply said, "Citizen assistance, ma'am. No charge for something like this."

A week later, Steve again had an episode of being unable to complete a short walk. With another 50 yards to go to the car, his body simply gave out. He sank a knee to the ground, laid down flat and called 911. The ambulance crew arrived, helped Steve to a gurney and lifted him into the ambulance. A mile later, they were home and brought him into the house and put him to bed. Again, "No charge, ma'am...this is a citizen assistance call."

Folks, this is the sort of thing which renews my faith in humanity. Emergency personnel basically volunteering their time to help out folks who, without their assistance, would be sunk.

I'd like to say a personal thanks to the Lake St. Louis Ambulance and Fire guys for helping out my uncle.

Columbia University School of Nursing

Tuesday, July 1, I was honored to be the keynote speaker for the Columbia University School of Nursing. Thanks to all the future Nurse Practitioners who have chosen an incredibly special field!

You guys were a fabulous, FABULOUS audience and I'm humbled by the response I got!

Special thanks to Dr. Norma Hannigan and Dr. Cook for making my appearance possible (and thanks to Norma for an awesome fish & chips lunch, too!) Thanks to all for making my journey to Columbia University so awesome!

Listen, Already!

Ever watched the show, Mystery Diagnosis?
If you're a health care pro – you might just learn something! Here's the 411 on this show...

Generally, a person is having some type of medical problem. The issue gets worse, they go to see a doc, the problem continues to get worse, they go see another doc, repeat repeat repeat.

Finally, the person is seen by a doctor who correctly diagnosis the problem. Why didn't the first doc get a better handle on it? Almost inevitably, the doc who gives the final diagnosis does so because he/she has done something no one else has bothered to do: Listen!

One of the docs interviewed tonight gave his philosophy on treating patients. He said, "I like the patient to tell me everything they can that's been going on, almost like telling me a story. Every pain, every bit of sickness, every kind of fatigue – I want to hear it all."

Tonight, his diagnosis was of a rare liver disease which, if monitored closely and treated correctly, shouldn't be a great inhibitor of the patient's life. Left untreated, death was imminent.

Now, docs who can put two and two together are better than health care pros who cannot. This doc took all of about eight minutes with his patient until he had the correct diagnosis. He listened, he asked the right questions and those streams of thought led to an accurate diagnosis (one that ultimately saved the life of his patient.)

Big, BIG keys to patient care:

1. Listen

2. Ask the right questions

Easier said than done? Sure, but is there any other way?

Your Staff is You, Doctor

I went to fill a prescription for eye drops this morning. If I have an eye inflammation flare up, this drop usually helps relieve some of the burning. Right to the source, no waiting for drugs to be absorbed into my system, etc.

As with all doctors, the prescribing physician has horrible handwriting. The script was written for four refills, but this was the first time I've filled it. The pharmacist couldn't read the doc's handwriting, so called the doc's office. Of course, the doc is out today, so the pharmacist spoke to the nurse. The doc had failed to log his script to me, so the nurse probably thinks I'm trying to pull one over on them. Am I? Jeez – if I wanted to get some drugs, don't you think I'd try to get something psycho active like Darvocet or Zanex? But no... I'm wanting to get some relief in drop form for eye inflammation and the pharmacist, the doc's office, seemingly every person I talk to is eyeing me suspiciously like I'm trying to commit a crime!

This will all be straightened out within the next hour or two (I hope), but the doctor's nurse is really hacking me off. I'm not a criminal, I'm not trying to pull one over on anyone, I just want the eye drops prescribed to me! As if getting screwed for $60 per bottle isn't bad enough, now I'm treated like a criminal.

Docs – your staff is you. It's crossed my mind not to return to this physician due to the treatment by his "people."

Will I actually find another doc? Nah, but I wish docs would take their job as boss as seriously as they take their job as physician.

Marcus is a Wii character?

My buddy, Kyle Kuhlman, just sent me this picture of a guy who, strangely enough, bears a close resemblence to moi! Here's his note that went with it:

Hey Marcus, I just got the Wii and made up a player of myself on the sports program. I put in all the attributes of myself, pulled up the picture and it looks remarkably like you.

So, faithful reader, what do you think? I'm a little disturbed that Wii has turned me into a video game character!

Pinellas Area Nurse Educators

Yesterday, I had the privilege of presenting to the Pinellas Area Nurse Educators. The PANE Conference was held in St. Petersburg, FL. These nurses are all employed in either a hospital or educational setting, instructing future R.N.s on ways to be excellent health care providers.

A special thanks goes to Tammy Franqueiro for being such an awesome client!

It was truly an honor to work with such a quality group of nurses who are helping to make the healing processes of patients much, much better!

A Recent Obituary

In my literary life, there have been four phases:

1. When I didn't know how to read (birth to 3 or so)

2. When I loved to read! (3 until, say, 13)

3. When I hated reading and only picked up a book when it was assigned (13-17)

4. When I re-learned some passion for the written word; so much so I began to create my own (17-present)

For the last four or five years of phase #2, I'd often check out books from the public library in Montgomery City (just a hop, skip and a jump from my hometown). On Saturday mornings, you could find me sitting on the floor in the back of the library, flipping through giant picture books of warfare; everything from spears to M-16s in the Vietnam Conflict. In those shelves was where I learned the value of just how much knowledge there is in the world-and that's probably why I want to know EVERYTHING now! The rebellious, slothful teenage years hadn't kicked into full gear, so I was still able to dig books just because, well, I dig books. It wasn't yet cool to NOT like reading (something I hope teens today don't emulate.)

Anyway, there at the Montgomery County Public Library was an elderly librarian named Laura. The things I remember about Laura were 1. she was a heavy, heavy smoker (yes, this was in the days when no one seemed to have a problem with smoking in the library) and 2. she seemed to know EVERYTHING about books! It was Laura who first introduced me to J.R.R. Tolkein and the Lord of the Rings trilogy-some 15 years before the movies made "Hobbitt" a household word!

While at my parents' home last week, my Mom was flipping through the local paper when she came across Laura's obituary. Laura hadn't really crossed my mind in years, but at the news of her passing, I thought back on those Saturday mornings. I also began to remember something Laura taught me without ever even knowing she was sending a lesson along...

Another library employee who worked with Laura was profoundly disabled. I don't think I ever knew this woman's name, and my best guess is that she had a severe case of cerebral palsey. This woman would sit behind Laura's desk in her electric wheelchair, body twisted at what looked like painful angles, jerky, robotic movements to sort books into large metal bins.

What I assume was C.P. had robbed this woman of all but the most sparce of motor functions. She could grip a book, but couldn't sit it down gently. Into the big metal bin the books would go, nearly shaking the windows with the clattering "BANG!" In the years I went to the library, this woman never spoke. Guessing here, but it seemed her disability wouldn't allow her verbal communication, either.

Sitting just a few feet away from Laura, she'd do her tasks of book organizing, books banging all the while. Laura, meanwhile, checked the cards in each of my loans, talked to me about the content of each, asked me about the last books, I'd read, never once paying attention to the ruckus being raised just a step away.

Was she oblivious to the noise? Unlikely. She was, however, comfortable working with this woman and her limitations. At the first loud slam, it would have seemed proper to drop what she was doing, run to the aid of the woman at the rear, check to see if everything was okay. But she didn't. Why? Probably because she knew nothing was wrong, just accepting this woman's disability and the tiny inconveniences that went along with it. She didn't offer help, didn't hover, just let the woman perform her task.

Laura certainly never acted like her co-worker had any sort of cognitive disability. To this day, I don't know if she did or not. My guess is no. She simply lived in a body that had more limitations than almost any other I've ever met. But Laura didn't treat her like she was profoundly disabled-she just let her do her job.

Frankly, Laura's comfort level with a person of this limited ability was disconcerting to my pre-teen self. It was, however, exactly how a person with a disability should be treated: with respect, honor and without making the disability their sole identity. Some of the best lessons are taught by inaction; when a loud crash would happen, Laura wouldn't even look up. I wanted to yell, "What happened?! Is she okay?!" all while pointing toward the figure in the electric wheelchair. But I didn't. Because Laura didn't act like anything was wrong. That made me also think nothing was wrong. Laura would finish her stamping of my books, wish me luck and would turn back to her own novel and overflowing ashtray.

You know, I'm not sure I'd ever thought of this until I heard of Laura's passing, but I have to think her actions (or more specifically, lack thereof) towards individuals with disabilities helped mold my opinions. Never assume that if one's body doesn't work well, that their mind doesn't, too. Don't hover, don't coddle, don't protect-just allow that person to live his/her life and to do their job.

When I became a person with a disability, I knew darned good and well I didn't want to be treated in a way other than the respect Laura showed her co-worker. I hope this memory may remind you, faithful reader, of how to respect and honor the existence of all people, those with disabilities and those without. If there's net access in the hereafter, I hope Laura may read this and rest assured she helped mold the life of one little bookworm many years ago.

Missouri Rehab Association

As promised, here are the pics from the MRA conference from earlier this week. It was truly a joy to be with all the MRA folks – again, these are some of the most giving, delightful people I could ever hope to work with! Left to right we have Frank, an assessment guru with A.O. of Springfield (and one of the kindest people you could ever hope to meet), my client, Kim Vaughn, a Voc Rehab counselor, moi, and Joe, an administrator with A.O. of Springfield (and one of the most professional, dedicated individuals I've ever worked with.) Thanks again, MRA, for doing what you do and for welcoming me into your conference! Y'all are a blast!

International Shriners Day!

In honor of the founding of the International Council of Shriners of North America on June 6, 1876, nobles (aka, Shriners) everywhere celebrate International Shrine Day!

Having just become a Shriner within the last few months, I'm proud to be celebrating my first Shrine Day. How does this work? Simple:

Nobles everywhere are to wear their red fez, a Shrine tee-shirt or a Shrine lapel pin-just to show their affiliation with the Shrine. If you've not seen a fez, take a look at that handsome devil in the pic...see that big thing on his head? No, not his nose! That red thing that looks like an inverted narrow bucket? That's the traditional Shriner's fez. Think wearing one of those to Wal-Mart may generate some awareness? If nothing else, it'll definitely show some fashion sense!

Still, what is the Shrine? What do they do? What do they believe? Why do they wear funny hats?

Simply put, the Shrine is a Masonic fraternity body created to have fun with a purpose. The fun results from fraternization, parties, socials, parades, etc., and the purpose remains the same: to support the Shriners Hospitals of North America.

Shriners Hospitals are some of the best medical care one can get for burns and orthopedic issues that confront children. No patient at a Shriners Hospital is ever charged a single penny-this makes the Shrine Hospitals the greatest philanthropy in the world. With a daily operating budget in excess of $2 million, the fun we nobles have is only surpassed by the incredible help given to children in need of intense medical care.

Happy Shrine Day to my fellow nobles!

If you'd like to learn more about the Shrine and the philanthropic work we Shriners do, please view:

www.Shrinenet.com

or my home Shrine's web page at:

www.BahiaShrine.com

Family Pharmacy Teams With Marcus!

Well, it's finally happened! Ever since the release of my books in the fall of 2006, I've looked for a retailer in my hometown. You'd think this wouldn't be so challenging, but it sure was!

Then, a retailer found me! In March, I was honored to be the key note speaker at the National Honor Society induction at my alma mater, Montgomery County R-2 in Montgomery City, MO.

Attending the induction of their daughter, Ellie, were Jack and Janet Holtman, owners of Family Pharmacy in Montgomery City. Mr. and Mrs. Holtman (and Ellie) purchased my books and passed them along to several others after they read them. As always, I'm humbled and honored when anyone passes my book along with the recommendation, "Hey, you should read this!"

Well, Jack and Janet also decided to inquire about becoming a retailer of "After This..." and "The Other End of The Stethoscope." I, of course, was ecstatic to be able to offer books to readers in my hometown by way of a local retailer!

Family Pharmacy is located on North Sturgeon in Montgomery City, MO. I hope folks from my home area will stop in, say HI to Jack and Janet, and maybe pick up a book while they're at it!

Special thanks to Jack and Janet Holtman for their desire to help me spread my message!

"I'm Just A Phone Call Away!"

Yesterday, I had my annual visit with my ophthalmologist , Dr. Moholtra. Why a blind guy needs to go see an eye doc every year, I dunno... but I go anyway.

Dr. Moholtra decided to try a different type of medication to help reduce conjunctivitis in both eyes (Ah, maybe THERE'S the reason to go see an eye doc). We discussed the benefits and drawbacks to this new medication, talked about if I should find an ophthalmologist in Florida, etc. As we discussed the pros and cons, Dr. Moholtra simply said, "And never forget that I'm just a phone call away."

THAT, faithful reader, is darned reassuring. I now know my physician will make time to return my call if I have any problems. Will he actually call me back? Doubtful. Might it be his nurse who returns my call? Probably.

Still, no matter what actually DOES happen, Dr. Moholtra said "call me" not "call my office" or "call the nurse."

How do I feel? Like I have a personal connection to my physician. Was that his intent? Absolutely! Dr. Moholtra knows the key to great patient care is the relationship between patient and caregiver. Simple as that. And such a professional thing to do which is, unfortunately, lacking so often in the medical world.

When You're a Professional...

I just got back from an appointment with a new dermatologist. It was a fairly wretched experience. The physician himself was a pretty good guy, but his staff? Yeesh. Awful.

Unfortunately, this doctor has missed one of the keys to being a professional - be sure the people representing you are professional, too. Here's how this went down... Marvelyne and I scheduled appointments back to back. We both wanted to hear what the doc had to say to the other. Fair enough, especially since my reason for the appt. was so the dermatologist could point out skin blemishes to Marvelyne I obviously don't see.

When the secretary called Marvelyne's name from the waiting room, I got up, too. Convo went down like this:
Secretary: "Sir, we'll see you when your wife is finished."
Marcus: "We're together."
Sec: "I'm sorry, but we don't see couples together. She can come get you when it's your turn." Marcus: "So, she can be in my appointment, but I can't be in hers? That doesn't make sense." Sec: "I'm sorry, sir, but that's our policy."

Now, folks, that was NOT their policy. In fact, when the doc came into Marvelyne's appt., she asked, "Can my husband be in here?" The doc's response was what it should be, "Of course!" Still, 10 minutes later, I was finally allowed into the exam room with my wife - and with a temper about at the boiling point. I'd not yet met the doc, but what do you think my overall impression was? Yep-negative.

Any professional knows he/she must, MUST have representatives who give a favorable impression. This doc does not have that person on his staff. In fact, instead of a non-issue (a worst case scenario for a physician's secretary), he has one who does harm.

This isn't to say the doc himself was bad. He was fine, but the impression was already made by his crappy secretary. After being represented by a speaker's bureau in the past, and after having different web designers creating work to represent me, and an army of past marketing folks, I know one thing - do NOT hire anyone who cannot properly represent me to others. I've made this mistake time and time again. Is it even possible not to? Sure, but just like finding Prince Charming, sometimes you've gotta kiss a lot of frogs The key is, when you realize the person representing you is a frog, it's time to make frog legs.

As a professional, I will never continue to allow someone to represent me in person, print, communication or video who cannot make me look fabulous. Seems like doctors need this lesson, too.

Western Regional Greek Association - WRGA

Sat., Ap. 12, I was honored to be a keynote presentor for the Western Regional Greek Association conference in San Francisco. This was a true pleasure to be in front of a fraternity/sorority audience once again!

Thanks to all who attended my presentation - we had so many fill the room we had to hang a sign on the door saying the room was full! Plus, this is one of those programs where we all (and I do mean everyone) seemed on exactly the same page at exactly the same time. I can only do that when the audience is ready to get on board and ride this roller coaster with me - and you guys did just that! Thanks!

I'd like to thank all the fellow Kappa Sigs I met at WRGA, too! Always great to meet brothers at these events!

Tampa Tribune Article

When I spoke at Academy At The Lakes last Monday, April 7, Megan Hussey of the Tampa Tribune was present. The article appeared in Saturday's Tribune and can be found below.

I'd like to personally thank Megan for such an accurate and well-written article! I've been written about hundreds of times in newspapers, magazines, periodicals, etc.-but this is probably the most accurate article ever done on little old me! Thanks, Megan, and thanks again to Bob Sullivan and Academy At the Lakes for hosting this event!


Speaker Helps Students See 'Happiness Is A Choice'
By MEGAN HUSSEY
Tribune correspondent
Published: April 12, 2008 LAND O' LAKES - At the age of 16, Marcus Engel was involved in the type of fender bender that every high-school student fears; one in which he accidentally struck an auto driven by his principal's wife. Taking the incident in stride, his principal advised him to "Change the things you can." This advice proved valuable two years later, when Engel was in another wreck, this one far more serious. One late night on a St. Louis road, the actions of a drunken driver in another car cost Engel his eyesight; and caused massive injuries to his face and body that required a year of surgeries to repair. Engel first had to accept the fact that he was blind. "I thought, 'I'm 18. I'm never going to see again. I'm never gonna lead my life again,'" he said. "What do you do?"
Reaching Teenagers
What Engel did in the years that followed was write two inspirational books and speak publicly about his experiences; his speaking engagements take the Orlando resident to 40 to 50 events yearly. "And because of my passion for education, I love speaking to schools," he said. "It's a powerful thing to get teenagers to listen, and judging from the number of e-mails and MySpace signups I get after my speeches, they are engaged by the message."

On Monday, Engel brought his message of hope, humor and inspiration to Academy at the Lakes, where he addressed students in grades eight through 12. Engel was accompanied by his wife and book editor Marvelyne Adams, and Carson, his guide dog. He also brought a bag full of his books, "After This ... An Inspirational Journey For All the Wrong Reasons" and "The Other End of the Stethoscope: 33 Insights for Excellent Patient Care." He handed out free copies to students who asked questions after the speech. He also handed out advice about overcoming terrible odds. "You get used to things like this, because sooner or later it just becomes your life," he said. "All I knew is that I had to give it time, that my life could someday be good again."

Working To Stay Independent Following his principal's advice to change the things he could, he took extensive steps to ensure that life would be good again. After a challenging regimen of surgeries and physical therapy, he attended a residential education program for the blind. "In order to graduate, I had to prepare, serve and clean up a meal for the 50 people on the school staff," he said. "For the second challenge, a school secretary took me out in a car ... and dropped me off, telling me I had to find my own way back. On my honor, I could only ask one question of a pedestrian to get back." "When she dropped me off, I soon realized I was 25 miles away from where I needed to be," he said. After successfully completing this program, Engel was able to return to college, and then took a summer job as a camp counselor. He taught and performed all of the same activities - such as swimming, canoeing and archery - as the other counselors. He says his greatest achievement may have been mentoring an overweight child who was bullied by campers.

"His mother wrote a letter saying that the only positive experience the boy had at camp was working with Marcus, the blind counselor, because the boy said, 'He couldn't see how fat I am,'" Engel said. "I spent all summer trying to show other people the things that I could do, and he was most impressed by the things I couldn't do."

Engel has dedicated much of his life to inspiring others; through his books, his speeches and occasionally through advising lawmakers about the establishment of meaningful drunken driving laws. Most of all he wants people to know that although his accident claimed his vision, it didn't cloud his view of the world.

"I'm pretty ecstatic about my life," he said. "Happiness is a choice."

MARCUS ENGEL
SOME BACKGROUND: On Monday, national inspirational speaker and author Marcus Engel addressed eighth to 12th grade students at Academy at the Lakes in Land O' Lakes. COMMUNITY

CONTRIBUTIONS: During his freshman year of college, Engel lost his eyesight and sustained massive injuries in an auto crash caused by a drunken driver. He now speaks to students and other audiences about overcoming insurmountable odds to find a fulfilling life.

A LITTLE HISTORY: In addition to his 40 to 50 speaking engagements a year, Engel has written two books.

GETTING INVOLVED: To learn more about Marcus Engel and his work, go to http://www.marcusengel.com/ or www.myspace.com/marcusengel.

Find this article online at: http://www2.tbo.com/content/2008/apr/12/pa-speaker-helps-students-see-happiness-is-a-choic

Any Questions?

"Any questions for the pharmacist?" the tech asked from behind the counter. I've been on this same medicine for two plus years, so I feel like a salty dog with it's use. I just shook my head and said, "Nope! I'm all good!"

Still, had I not been so familiar with this drug, I'd have had a lot of questions. Going to the pharmacy can be pretty intimidating for some. Insurance cards, co-pays, signatures, prescribing doctors, prescription slips, directions for the medication, tiny print, unfamiliar words - if I were elderly, there are tons of reasons why seeing the pharmacist could be a struggle.

By the tech asking, "Any questions for the pharmacist?" it opens a friendly door for conversation. This pharmacy seems to have this as their policy - not just the happenstance comment of an employee. With as much confusion as can be with drugs today, this makes lots of sense.

In fact, were I recommending a pharmacy to an elderly loved one, this is the first place I'd suggest. If nothing else, they make it easy for the patient to learn more about the medications they're on.

Who Benefits?

Jamie Allman is an investigative reporter back in my hometown of St. Louis. In the last several years, Jamie's claim to fame is no longer the investigative reporting, but sharing the truth about national and international situations. Basically, if it happens on earth, Jamie is going to get to the bottom of what iss REALLY going on.

Today, I happened across his blog, Allman's Electric Stove. You can search it out through:

www.971talk.com

One of his articles asks the question, "Who benefits?" He said in his time as an investigative reporter, the single best question one can ask during an investigation is, "Who benefits?"

Someday I'll probably write a book on how I don't believe in alturism(the idea one performs selfless acts for the benefit of another). I believe we can all have selfless feelings, but even the best act of chairity(that being anonymous) still gives the giver a good feeling about his/her deed.

Anyway, if you ask, "Who benefits?", I think you can get to the bottom of the story fastest(and I've thought this for years, Jamie just shortened it for me). When learning of leaks in the press, who benefits? Chances are, there's your culprit. When there's a crime committed, who benefits? When there's a political issue, who benefits?

And ya know what? Most people will never ask this question. And because of that, most guilty parties will get off scot free. This lacsidasical attitude on the part of we Americans is precisely why we're such lemmings when it comes to news.

What's that? You say you're not? Awesome! I don't think of myself as a lemming, either. But ya know what? Unless I ask some real pointed questions, I do, in fact, end up eating whatever the media machine pushes out. Sad fact of life...which is why I'll continue to try to self educate as much as I can. I hope you will, too.