jenuesse health

A danger of being " Thinker in Residence " for several months here in the state of Victoria, Australia, is the danger of diagnostic anchoring--too quickly reaching conclusions about the state of the health care system--followed by confirmation bias--valuing only those observations that support the conclusion you've reached, while ignoring other data.  With cognitive errors of this sort, the best defense in avoiding them is to be aware of their existence.  So, I've tried assiduously to be careful during my visit here.  But the time has come to offer my considered view on several matters. In a recent blog post , I noted that the extensive program of traffic safety run by the Transport Accident Commission is an example of the strong sense of communitarianism that pervades this society.  I suggested that a future column would explore whether this communitarian view within Victorian society carries over into health care--whether there is a comparable commitment "towa...

It isn't often that I can report that I was honored to see a play, but such was the case recently when I was invited to view the showing of a short four-person drama at West Gippsland Hospital in Warragul and especially because I was permitted to attend the staff discussion that followed the performance.  Here's the background: The Australian Institute for Patient and Family Centred Care was established a few years ago by Catherine Crock and colleagues to promote just what its name implies.  As noted: We aim to to transform people’s experience of healthcare through a three-fold approach: Develop partnerships between patients, their families and health professionals Create a culture that is both supportive and effective Improve healthcare environments through high-quality integrated art, architecture and design. One medium used by the AIPFCC is to commission short plays on key themes in health care delivery and present them, upon invitation, to hospitals throughout the count...

In America, drivers don't try to kill other drivers. In Australia, drivers try not to kill other drivers. After almost three months here, I've decided that this difference in attitudes is the biggest thing that separates these two cultures. America was built on a culture of individualism, sometimes called "rugged individualism."  In Australia, society is characterized by a much greater degree of communitarianism. The place of traffic fatalities in the two countries provides a nice example. There are about 32,000 traffic-related fatalities in the US per year, about 10 per 100,000 population .  I think if you were to ask most American drivers about this figure, they would probably answer, "These things happen."  There is virtually no concern in the general population about these deaths, and there is certainly little or no evidence that road dangers influence the manner in which people drive. In Australia, there are about 1200 deaths per year, or about 5 per 10...

When I was growing up, ultimate (originally known as ultimate frisbee) had not yet been invented .  While we played with frisbees, it was mainly just a lot of tossing them around.  Since then, the sport has developed and highly skilled players and teams compete worldwide. I've had a forced sabbatical from playing soccer here in Melbourne (no one plays during the summer apparently), but have been lucky to be invited to join a local co-ed division three ultimate team.  It's been great fun to play a sport which in which the rules are self-enforced, i.e., without referees, and where the "spirit of the game" is the dominant culture. Nonethless, there remains a role for a team leader, often a player-coach, and in this case we are blessed to have Michelle Phillips, a world class player, as ours.  Off the field, she and I have traded stories about leadership, and I've also had a chance to watch her skills in that regard during games and her post-game advisories to the tea...

Today's story is about how to implement a cultural change among a large group of people.  Stick with me, as this will take a moment. Back in 2001 the Victoria Transport Accident Commission wanted people to slow down just a bit while driving.  They understood that "Speeding just 5km/hr over the speed limit can mean the difference between a close call and a serious accident."  The question was how to get people to do it, and do it consistently.  Of course, you could have police and traffic cameras trying to enforce the speed limit, but that is resource intensive and can never be pervasive enough to hold thousands of drivers accountable to this standard. It would be better if people would internalize the message and hold themselves accountable. What resulted was the Wipe off 5 campaign .  TAC employed a simple statement of principle and combined it with an easily understood and remembered action that every driver could take. The fact statement was pretty strai...

I was recently directed to a lovely example of how an observation of correlation can be misinterpreted with regard to cause and effect.*  It comes from Mind of the Raven by Bernd Heinrich.  Here's the excerpt: At dusk on September 7, 1997, a cougar crept up on Ginny Hannum as she was working at the back of her cabin at the head of Boulder Canyon in Colorado.  The cougar crouched low among the rocks, facing her from about twenty feet, and it was ready to pounce.   Although Mrs. Hannum was unaware of the cougar's presence, she had become "somewhat annoyed" by a raven "putting on a fuss like crazy.  The noisy raven kept coming closer, having started its commotion twenty minutes earlier from about three hundred yards away.  Was this raven trying to say something?  She started to listen more closely. The cougar was ready to make its kill, but the raven was close, and it made pass over the woman, calling raucously, then flying up above her to some rock...

A friend here in Melbourne visiting a doctor in the community took this picture from the bulletin board in the doctor's waiting room.  I posted it on Facebook with the comment: "I know some doctors feel frustrated about this issue, but even if they do, is the waiting room a really good place to put up a sign like this?" Within hours, I received a slew of comments, and I repeat a few of them here. Condescending, much? Gotta fight snark with snark! My search engine spends more than 2 minutes with me, doesn't disregard my input, and is available for follow up...so it'd be hard to confuse with a real doc.  It is offensive to put that in a waiting room. Period. I would turn right around and walk out. I'd turn around and walk right out too, if I could. Great example of an ego-based practice! Yikes, not at all appropriate for posting in a waiting room.   Don't confuse your medical degree with human empathy. We have had some great doctors lately so have res...