May 2013
1 post
Breaking the Silence: Boston Marathon bombings
I recently published a blog on the Boston Marathon bombings. Like many people, I have personal connections to Boston. My son was near the finish line when the bombings occurred. I was spared the anxiety of having to wait for information about his safety. I found out about the bombings at the same time my daughter texted me to say that Michael was safe.
Scores of others were not so lucky,...
April 2013
3 posts
End of Life
Tuesday was National Healthcare Decisions Day. The day serves as a reminder to answer the question of who will speak for you regarding important medical decisions if you cannot speak for yourself.
Planning for end of life entails conversations with loved ones about your preferences and values that will help guide medical decisions at the end of life. You should also select a substitute...
Terror
Monday started as a usual day. At 3:36 my daughter texted me the following message:
I don’t know if you heard about the Boston Marathon explosion, but Michael is fine. I think they might have shut down phones so if can’t call him that’s why, but he posted on face book.
My son Michael was at the finish line waiting for a friend to complete the race. Within minutes of my daughter’s text the phones...
Empathy
I’d like to share a fascinating video with you. In it, a camera tracks through the hallways and rooms of a hospital in real time, capturing the actions and interactions of 38 people (and one dog), in four and a half minutes. There are no spoken words – only written captions that appear over peoples’ shoulders indicating their private thoughts. Some of the captions express joy (“first vacation in...
March 2013
2 posts
Being "present" saves lives
The simple act of one human being “present” for another saves lives. According to a fascinating New York Times column, simple listening could contribute to solving the Medicare cost problem. In this time of spiraling health care technology costs, we overlook simple but profoundly effective activities.
These radical statements echoed in my mind as I attended an event to recognize volunteers in the...
Team work and a culture of safety
Katie Goehner, RN has been part of the Methodist Hospital team since she was born 30 years ago. Her father, Dick Barrett, worked in the Methodist Safety and Security office when Katie was delivered more than a month prematurely by emergency C-section with very immature lungs and weighing just 2 pounds, 11 ounces. Katie’s Dad used to go upstairs to help feed her during his work breaks as she slowly...
January 2013
1 post
Looking Backward, Looking Forward
On January 1, 2013, Park Nicollet and HealthPartners officially combined. How appropriate this event occurred in the month of January. The ancient Romans named January after Janus, the god of beginnings, transitions, gates, doors, endings and time. In Roman mythology Janus has two faces, one looking back at the past and one looking ahead to the future. The image of Janus simultaneously peering...
December 2012
4 posts
Pay it Forward
DrAbelsonConnects is on vacation during the holidays. We hope you’ll enjoy this post originally published in October 2010.
The film, “Pay it Forward, depicts young Trevor McKinney, engaged in an intriguing assignment from his new social studies teacher, Mr. Simonet. Trevor must create an opportunity to make a positive difference in the world. Trevor conjures the notion of not “paying back”...
Dealing with Tragedy: Remember What You Live For
“What do you live for?” is an important question at Park Nicollet. The question embodies the “noble cause” of health care. Living for something is an essential part of wellbeing. Our role at Park Nicollet is to support wellbeing by enhancing the ability of people to participate in life as fully as possible. We’ve made the question the theme of Park Nicollet’s marketing campaign...
Touch and Technology in Patient Care
At one clinic, an experienced physician uses the tips of his fingers to probe a patient’s neck and feel for any abnormalities. At another clinic, a young physician uses the tips of his fingers to launch a smart phone app that details the symptoms of thyroid disease.
Which physician is practicing the most effective kind of medicine?
The tension between touch and technology in healthcare is a...
Curiosity
Today, NASA scientists are announcing the latest findings in their search for life on Mars, reporting data from the “rover” that travels the surface of the planet looking for signs of life. What is the name of NASA’s rover? “Curiosity,” named after the force that sends people forward in life to ask questions and search for answers.
Maintaining a sense of curiosity is an attitude that enhances our...
November 2012
3 posts
Thanksgiving: What a difference a letter can make
A recent article, published in the Journal of Clinical Oncology by our own Steve Duane M.D., brought tears to my eyes. Steve is a physician in the Park Nicollet Hospice Program. In his article, Steve movingly describes his experience with junior high students in the “Growing Through Grief” program sponsored by the Park Nicollet Foundation.
Growing Through Grief is a school based program that...
Irritability and Compassion
Most interactions between staff and patients and their family members go well. Occasionally, we disappoint. A colleague recently told me the following poignant story about Janet Stensgaard, a parking lot attendant on the Park Nicollet Methodist Hospital campus. The story illustrates how each of us has the potential to reach out to patients and improve their outcome even after they feel dejected...
Medical Ethics and the Flu
I’d like to share with you a blog post I recently sent to all Park Nicollet team members regarding the importance of vaccinating healthcare workers against the flu.
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“Beneficence” describes our ethical obligation to act in the best interest of others; non-maleficence denotes our ethical duty to “do no harm” (a common principle in healthcare). Patients and families trust that we...
October 2012
5 posts
Unwavering commitment to patients, community
As I watch news reports of the devastation caused by Hurricane Sandy on the East Coast, I feel sorrow for the human suffering and continued concern for people who live in the path of the storm, including some of my own relatives and friends who live on the Eastern Seaboard. I’m sure that many people reading this also have relatives and friends who live in affected areas of the East Coast. My...
Teamwork essential in life and at Park Nicollet
Laura O’Donnell is a Certified Medical Assistant with Park Nicollet Senior Services. She has worked here for 11 years and also spent six years as an Air Force medic.
In her free time, Laura enjoys making jewelry and sometimes exhibits at local arts and crafts shows. In July, Laura was exhibiting at “River Town Days” in Hastings, a beautiful town encompassed by three major rivers. Suddenly, the...
Best Care at Lowest Cost – new Institute of...
The Institute of Medicine (IOM), an independent, nonprofit organization that is part of the National Academy of Sciences, issued a major report recently called “Best Care at Lower Cost.”
At 450 pages, it’s a big report and it’s garnering big headlines in the news media – but not, unfortunately, a lot of insight. Most news coverage focuses on the IOM’s estimate of the amount of waste in health...
Caring for Colleagues
It is very common for people who work in healthcare to receive their own care where they work. At Park Nicollet Health Services, most of our team members and their families receive their care from Park Nicollet.
Seeking healthcare from your own colleagues represents the ultimate in trust. When we go to our colleagues as patients, we signal our trust in their professionalism, skills, knowledge and...
What do you live for?
“What do you live for?” is an important question at Park Nicollet. The question embodies the “noble cause” of health care. Living for something is an essential part of wellbeing. Our role at Park Nicollet is to support wellbeing by enhancing the ability of people to participate in life as fully as possible. We’ve made the question the theme of Park Nicollet’s marketing campaign...
September 2012
2 posts
Underuse, Overuse and the Triple Aim in Healthcare
I have written previously about the potential overuse of certain tests and diagnostic procedures in health care. In April, nine prominent medical society boards identified 45 common medical tests and procedures that they say are overused and, in some instances, may be unnecessary. In July, New York Times health care reporter Tara Parker-Pope wrote a compelling article about her own family’s...
Cost and Quality
Cost and Quality
Too often I hear people say: “You can’t have low cost and high quality at the same time. You certainly can’t have it fast (timely access), good (quality) and inexpensive. At the most, pick two out of three.”
Following the “Triple Aim,” healthcare needs to do all three simultaneously- great experiences for individuals and outstanding outcomes for populations at...
August 2012
1 post
Unnecessary tests and treatments in healthcare
The goal of every clinician is to help their patients become as healthy as possible. When a patient breaks an arm, for example, we all share the same preferred outcome: we want to heal the broken bone and restore normal function to the arm. Many times, the cost of achieving the preferred outcome varies widely, often depending upon where the patient lives. Some clinicians in one area may use more...
June 2012
7 posts
Affordable Care Act upheld by Supreme Court
Today’s ruling by the Supreme Court of the United States to uphold the Affordable Care Act passed by Congress in 2010 is significant news in a healthcare marketplace where reform is not only needed, it is already occurring independent of court rulings and politics.[[MORE]]
As I have written about previously, the traditional, volume-based fee-for-service model of healthcare is broken. Our payers...
Summer reading list
DrAbelsonConnects is on summer break, but Dr. Abelson left behind some books to recommend to you from his summer reading list. Here are the first of his summer reading recommendations. [[MORE]]
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I use TED talks as a trusted source to help me find good books to read. TED is a nonprofit dedicated to “Ideas Worth Spreading.”
I recently listened to two TED talks that lead me to excellent...
Providing compassionate care in the moment
Observe any operating room in Park Nicollet Methodist Hospital before the first incision and you witness a beehive of activity as nurses and clinicians double check their surgical instruments, verify x-rays and make sure everything is ready for surgery. Suddenly, the pace slows as all team members stop to deliberately ask and answer key safety questions: [[MORE]]“Is this person the right patient?...
Should doctors show their grief?
How physicians and clinicians cope with treating the terminally ill
Craig (name changed to protect confidentiality) taught me how tough physicians should grieve. They shouldn’t. Craig and I were about the same age and we also had sons who were close in age. Craig suffered from advanced lymphoma that no longer responded to chemotherapy. He knew from his shortness of breath and growing disfiguring...
Privileged Presence and palliative care
The story below, She Sang Him His Life, from the book Privileged Presence- Personal Stories of Connections in Health Care captures my sense of reverence for working with patients and families.
Palliative care seems to be a place where anything goes. On our unit, the hours are completely open; people come and go as they need; pets visit. Staff pay attention to so many little details of...
How can we make healthcare more personal?
A simple request engenders tearful emotions illustrating what is just beneath the surface of our work in healthcare. I frequently speak with teams throughout Park Nicollet about the patient and family experience. I open each session by reading a story, Making the Unbearable Bearable, from the book “Privileged Presence.” The story, written by Kenneth Schwartz, describes his 9 month struggle...
Bird feeders and healing environments
Every summer my family and I spend a week in a lake cabin by Nisswa, Minnesota. Waking up before the others, I enjoy a quiet routine of sipping coffee while gazing at a birdfeeder immediately outside the window. I lose track of time watching colorful finches flitting in and out. Their activity fills me with wonder about the richness and variety of nature.
Recently, a patient and his wife...
May 2012
9 posts
Look inside for the true patient experience in...
My most recent blog, “In healthcare, small gestures provide big outcomes” provoked much discussion at Park Nicollet. Two of our physicians have similar stories which they share below.
See the person inside, Bill Anderson, MD
Several years ago I learned a similar lesson when I was caring for an older woman who was dying from pulmonary fibrosis. Left handicapped from her disease she was wheelchair...
Memorial Day
DrAblesonConnects will be back with a new post on Wednesday, May 30th.
In healthcare, small gestures provide big outcomes
Don Berwick, M.D. the former administrator for the Centers for Medicare and Medicaid Services (CMS) and former President of the Institute for Healthcare Improvement (IHI) delivered a moving commencement address to his daughter’s graduating class from Yale Medical School. The following passages triggered a flood of memories from my early days as a young physician.[[MORE]]
“What is at stake...
Belief and healing relationships in healthcare
Healthcare is a rigorous discipline grounded in hard science. Over the course of my 36 years as a physician, I have also come to understand the power of belief in healing relationships. Today, as a healthcare CEO, I have the opportunity to lead an organization that recognizes and celebrates the importance of belief in healing relationships.
That was not the case in 1975, however, when I was a...
Steve Jobs and coordinated care
Steve Jobs, the co-founder of Apple and former director of Pixar, died last fall from a rare form of pancreatic cancer. His medical care exemplifies the promise and problems of modern healthcare.
[[MORE]]Jobs transformed multiple industries including personal computing with the Apple II, animated movies with Pixar, the music industry with the iPod, mobile phones with the iPhone and publishing and...
Facing healthcare reform with Head + Heart,...
A great experience must be the foundation of everything we do at Park Nicollet. Patients and families tend to judge quality through the lens of their experiences. Indeed, what we typically think of as clinical quality flows from healing relationships between patients, their families and healthcare providers.
Additionally, when patients and families are pleased with their experience, they become...
Healthcare rituals and medical technology
Picture the following doctor and patient interactions from my time as a practicing physician.
Patient A. Every few weeks, I get a momentary stabbing pain right here on my chest. It feels like an electric shock.
Dr. Abelson. Already knowing the symptom does not represent anything serious, I listen to the heart and lungs, palpate the abdomen and check knee reflexes.
Patient B. Sometimes my stools...
National nurses week: a nurse's story
National Nurses Week begins May 6th and ends on May 12th, the birthday of Florence Nightingale, the founder of modern nursing. This year’s national theme is “Nurses—Advocating, Leading, Caring,” representing nurses’ caring and professionalism - be it at the bedside or in the halls of Congress.
The following article submitted by Sarah Pangarakis, Critical Care Nurse Specialist, to the journal of...
Lessons from a mentor
The following poignant essay by Bill Shimp MD, brought tears to my eyes. Bill joined Park Nicollet in 1976 and left in 2000. He served as vice president for the hospital and consultative care from 1996-1998 and as Chief Medical Officer from 1998-2000. Bud Green, an early founder of Saint Louis Park Medical Center, is the mentor.
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Lessons from a Mentor: When the Science is not Enough ...
April 2012
9 posts
Just for a moment
An ancient story describes a traveler seeking a spiritual teacher. Entering a village, he inquires about the teacher’s whereabouts. A villager, pointing in the direction of a funeral, says “you will recognize him as the one wearing the multicolored turban.” Nearing the funeral, he notices everyone wearing a multicolored turban.
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“How could this be?” he thinks to himself. As the...
More is magic
I travel through daily life protected by a veil masking the unforeseen that might befall my loved ones and me. Unfortunately, the veil temporarily lifted during a single week in December when my wife entered my office, shaken, after a mass was discovered during a routine exam; days later, I received a call that my daughter, an avid cyclist, sustained a concussion requiring a two day...
What "connects" with you? Let me know!
Health care was very different when I was a young medical resident in the 1970s. Frankly, many policies and procedures were designed for the convenience of physicians and clinicians. Health care administrators decided what worked best for their organizations and just assumed that patients would figure out how to navigate the system.
I was never comfortable with that outlook even at the start of my...
Navigation
I celebrated my 60th birthday by biking with a friend in the Tucson Sonoran desert. The work of a CEO, like many jobs, can be consuming and stressful. Surrounded by towering 200 year old saguaro cacti with oddly human profiles, I pondered my lack of preoccupation with “life balance.”
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For many years, I attempted to “balance” family, work, friends and personal time. Having maintained...
Honoring Choices -- Having the Conversation
My mother, of blessed memory, died peacefully at home at age 60 of progressive ovarian cancer. She died in 1984 according to her wishes, surrounded by loved ones in the familiar intimacy of her home. Fortunately, my mother discussed with us her desires and documented them in a “Living Will” prior to her death. Characteristic of how she lived, she took good care of her loved ones by sharing...
Exquisite attention
A Zen saying declares, when the student is ready, the teacher will appear. A teacher recently appeared.
Gary Gibson, an access assistant at Park Nicollet Clinic’s 3850 building, recently taught me about the “patient experience.” Gary and his colleagues are Park Nicollet’s “ambassadors of good will.” Helping people in and out of our buildings, they create...
Getting Older
My father, age 87, is a retired rabbi. He continues to deliver sermons during the Jewish High Holidays. This year he described his thoughts about aging in a sermon entitled “Getting Older.” He cites a poem, “Written by a Crabby Old Woman”, which I found applicable to the patient and family experience. I took the liberty of using my name in the poem so I would hear the crabby old woman speaking...
The cost curve
I received an email recently from one of our physicians expressing frustration about the growing number of patients who were unable to afford his recommendations. His patients either a) didn’t have insurance, b) were about to lose their insurance, or c) had high deductibles.
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The problems our colleague is experiencing provide a tiny glimpse of the impact of what I call the “cost curve” –...
Pay it forward
The film, “Pay it Forward, depicts young Trevor McKinney, engaged in an intriguing assignment from his new social studies teacher, Mr. Simonet. Trevor must create an opportunity to make a positive difference in the world. Trevor conjures the notion of not “paying back” a favor, but “paying it forward.” He intends to repay one good deed, by generating several new ones on behalf of three new...
March 2012
9 posts
Healing
Our mission is to “support the health, healing and learning of those we serve.”
Shirley, a 79 year old patient at Methodist Hospital taught me the meaning of “healing” on a Saturday many years ago. On that particular weekend, I drove to the hospital resentful and feeling sorry for myself for being on call and missing family activities.
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As her physician for...
Health care and zip codes
If you are 65 or older, what do you think is the best predictor of the volume of healthcare services you receive for a given condition or concern. Is it your financial wealth? Race? Ethnicity?
The answer: none of the above.
It’s your zip code.
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Everything’s bigger in Texas
In an influential article in The New Yorker magazine called “The Cost Conumdrum,” author and physician Awtul Gawande...
Words we use
Our words direct thoughts and feelings. When interacting with patients our word choices shape our views.
During my formal medical training, I innately desired to support and understand individuals struggling to adjust to a clinical diagnosis. As an eager medical student, I valued learning how another human being makes meaning from their medical condition. However, the training culture eroded my...
