Who Is A Healthcare Professional?

When you view the About section on the Doximity website, you find the following:

“About Doximity, Inc.

Our hope

A timely lab result, the right referral, a quick phone consult — we have all seen that better communication can result in meaningfully better   patient outcomes. In an age of competing health systems and disconnected “data silos,” we hope that Doximity can help connect the people that matter most — the professionals at the point-of-care.”

The fact that a group is taking a stab at this I am greatly excited about.  I’m equally ecstatic that Doximity is serious in their mission to provide exclusivity in regard to whom has access to privileged communication within the platform (meaning direct messaging and expanded contact info beyond phone #’s).  Trust me, I know.  I got denied access.  Don’t mistake the tone I am trying to set for this post.  No sarcasm is intended when I say I am happy that the platform is exclusive.  Yeah, I gave it my best shot to get privileges and got denied.  Though I was not surprised at the denial.   In my pitch to Doximity technical support to allow me access I included the following:

“My interests lie in healthcare innovation, to include my curiosity at how social media networks and EMR will be affected by ever changing technology.   Finding out what physicians are talking about in reference to these topics is where my greatest motivation lies for joining your group.  By knowing what physicians value and need in reference to these topics will allow me to better serve them as I communicate mental health treatment issues of their patients.”

I think that many healthcare professionals work under the same assumption as I do in that Doximity is a start; a beginning.  We are not sure of how long this beta platform will be around, though it is these groups that have the potential at defining the evolution of the concept itself, and that is why we follow closely.   My effort at getting as much “inside the machine” as I could was my way of observing this beast of possibility.  I intend for the aforementioned body of this post to be an introduction to your reading the letter I wrote to Doximity technical support after being denied privileged communication.  My purpose in writing Doximity was not to take a jab at their policy, but to encourage discussion on which healthcare professionals are excluded from privileged communication within the platform, and how this exclusion may affect Doximitys’ optimal level of success at achieving meaningfully better patient outcomes.  The unedited text is as follows.  Thank you for reading my post, and I welcome your comments, as igniting a discussion is my true purpose in writing:

“Doximity,

Thank you for consideration, time, and research involved with my request and for relaying results.  I certainly fully understand why I am denied privileged access to certain functionality within your Doximity platform.  A point of consideration and related discussion for your organization may be in how mental health treatment / related organizations and individuals could play a role in your mission.

A Psychiatrist may be able to achieve privileged status on your platform, while a Geriatric Clinician / Admissions Director for an inpatient psychiatric unit, such as myself (resume attached), would not.  Consider the value of a quick consult between someone doing admission assessments having been referred to do so by physicians, psychiatrists, RN’s, nurse practitioners, etc.

There are thousands of Mental Health Clinicians out there beating the streets in “road warrior” style having to call and interrupt physicians providing treatment throughout the day gathering information, requesting lab results, relaying results of home assessments, etc.  What a service it would be for them to connect with physicians in such a way as you have created.

I see the value of restricting your site to physicians only, and am actually thrilled to see it actively being done (by my own experience in being denied privileged access!).  So in this sense, keep pushing people like me away.  Though, keep in mind, as you will inevitably be challenged by much more pushy people with marketing interests, that there are people out there like me; A Mental Health Clinician with a great knowledge of behavioral medicine, though no doctorate degree to account for my knowledge and expertise in communicating with medical professionals during the process of either accepting or denying patients referred for treatment.

I ask that you review your statement found in the “About” section of your website to decide for yourself if anything I’ve said rings true :

“A timely lab result, the right referral, a quick phone consult — we have all seen that better communication can result in meaningfully better patient outcomes. In an age of competing health systems and disconnected “data silos,” we hope that Doximity can help connect the people that matter most — the professionals at the point-of-care.”

Being that your mission is to serve “the professionals at the point-of-care” …you have got me there.  Though considering my viewpoint may give you a perspective of a role often overlooked.

Thank you,

Jason Young, MS

Following Changes In Health Information Technology

Recently I’ve become more and more interested in following news related to HealthIT changes and their implications.  I’m excited about the role of technology in providing more effective and efficient care as the possibilities seem to be becoming more and more infinite.    Though in choosing outlets to digest HealthIT news,  one quickly runs into an ocean of black and white perspectives with not much gray to be found.  I am referring to those that either speak in terms of technology progression as being imperative without acknowledging negative implications or those having viewpoints based in ignorance resulting in fear of change altogether.

If you are interested taking in global perspectives that focus on an innovative approach to HealthIT integration,  I suggest following these twitter accounts;  KentBottles,  ahier,  kevinmd, and berci.   HealthIT is by no means all that these professionals focus on, though even when commenting on other topics, their information always encourages inspiration no matter what realm of healthcare you are associated with.

For all my eldercare product & services providers out there,  a great start to formulating your viewpoint on HealthIT would be to read the article,  “The Health IT Paradox:  Why More Data Doesn’t Always Mean Better Care” by Dr. Zachary F. Meisel.  It utilizes an example of an elderly woman being brought to the ER with minimal information to assist with diagnosis that demonstrates current issues related to HealthIT very well.

Treat Conditions, Not Symptoms

Let’s say, for example,  I went to my local emergency room with a broken leg.  Instead of setting my leg in a cast to heal, the E.R. physician makes the poor choice of giving me an excessive amount of pain medication so  I could not feel the entire lower half of my body, much less the localized pain associated with my leg injury, and sends me home with a broken leg and a prescription for more pain meds.  The doctor would have treated the symptom, being my pain, and not the condition, being my broken leg.

Very often senior adults are prescribed benzodiazepines (anti-anxiety medications) by their family physicians for such symptoms as sleeplessness, agitation, and verbal / physical aggression.  Often these symptoms are being caused / exacerbated by conditions such as psychosis and/or depression.  In these cases, attempting to treat symptoms with anti-anxiety medications usually leads to worsening of the condition, over-sedation, and increased confusion and disorientation.

The most important factor in avoiding the pitfalls being outlined in this post is the completion of  a comprehensive and thorough assessment of the problem.  Side effects and contraindications among prescribed medications are often the source of many problems.  Exploration of this and the presence of infections / new medical conditions are the two interventions that should first be initiated.  Once these interventions have been completed,  considering the prescription of anti-psychotic and/or anti-depressant medications should take place.

In my experience, most primary physicians are comfortable prescribing anti-anxiety and anti-depressant medications to try and address symptoms related to dementia.  Most though, would prefer an inpatient psychiatric evaluation be completed to best identify the condition or conditions present, and in the event medications are needed to address psychosis, have the condition(s) treated by a psychiatrist to best handle the introduction of appropriate psychotropics.

For more information on the topic of inpatient hospitalization in these types of treatment scenarios, please click on the following link:   “The Road Less Traveled; The Geriatric Psychiatric Option”

Webicina & PeRSSonalized Geriatrics

Dr. Bertalan Mesko, founder of Webicina, allowed me the opportunity to collaborate with him on the creation of the PeRSSonalized Geriatrics.  I was fortunate to get input from other professionals while working on this project.  These persons included Patricia Grace, founder & CEO of Aging with Grace, and Dennis Fortier, President of Medical Care Corporation and author of the blog, “Brain Today”.

Webicina offers personalized medical web 2.0 packages that provide patients and physicians with all the web 2.0 tools they need to know about a medical specialty or medical condition.   PeRSSonalized Medicine is a free, easy-to-use aggregator of quality medical information that lets you select your favorite resources and read the latest news and articles about a medical specialty or a medical condition in one personalized place.

I encourage all those interested in the care of seniors to explore the PeRSSonalized Geriatrics section within Webicina.   Finding a collection of resources of this caliber without such an aggregator would be near impossible.  

Ann Myers Medical Center within Second Life

Click the picture above for Slideshare link to presentation I gave at the Ann Myers Medical Center within Second Life.  Second Life is the Internet’s largest user-created , 3D virtual world community.  Training and education possibilities within this platform are endless.  I was provided this opportunity by Dr. Bertalan Mesko, creator of Scienceroll.

Importance Of Fall Prevention

Training healthcare professionals and family caregivers on ways to prevent differing types of dementia is one of my favorite things in life.   For example, when explaining the link between heart health and the avoidance of Vascular Dementia, it is often something a person has never even considered.  Fall prevention efforts made to avoid bodily injury is often at the forefront of caregivers minds, though doing so to avoid Dementia Due To Head Trauma is not.

There have been many articles written over the past few months that address this topic.  I am posting messages on my Twitter account today that contain links to some of these articles.  If you know of any websites / articles / materials that address fall prevention, please either direct message me on Twitter or email me at jason.young99@yahoo.com as I am putting together an updated training and would greatly appreciate your collaboration.  Any comments / tips are welcome on this post as well.

Thank you all,

Jason

Make The Choice To React Differently To Behaviors

I am often asked to train nurses on how to deal with the aggressive behaviors of their patients.  I always say, “There is nothing you can do.”.   After I absorb the blank stare I am always sure to receive, I go on to explain that once a person has become aggressive, it is too late to apply techniques to keep aggression from occurring.  Our effort should then be placed on learning how to better communicate with those having cognitive problems, and thus increase our ability to assess mild levels of agitation and minimize escalation of aggressive behavior after it has already begun.

The following are my, “Top 10 Ways To React Differently To Behaviors”.  While the suggestions are often simple for caregivers to understand, the hard part is in getting the caregiver to make the choice to implement them into their routine.  After reviewing my suggestions, please leave a comment with any way you are able to incorporate the skills into your own caregiving.

1.  Patients cannot change their behavior.  Change your reaction to the behavior.

2.  Respect the patient while the patient is not respecting you.

3.  Allow the patient adequate time to speak and respond.

4.  Speak slowly and deliberately while aggression is occurring.

5.  Speak in a non-threatening tone of voice and don’t threaten patient.

6.  Expect disorientation and choose to orient patient during conversation.

7.  Expect delusional thinking and choose to agree with patients beliefs.

8.  Keep expectations realistic given the degree of impairment.

9.  Repeat questions using the same wording when you are not being understood.

10.  Convey love and affection through holding hands and providing praise.

“Ask an Expert” with Aging with Grace

I’ve been blessed with the opportunity of  serving Aging with Grace and their clientele within the new “Ask an Expert” program.  This exciting project incorporates the strengths of a diverse group of professionals in an effort to help you and your loved ones.

I am a Geriatric Clinician with over 10 years experience diagnosing and treating mental illness in the elderly population, in both outpatient and inpatient settings.   Learn more about me by clicking here>  BIO.   I look forward to exploring with you how my expertise may be of assistance to you during our free 15 minute consultation.

Email me with a date and time you would like to be reached along with your phone number and I will call.

jason.young99@yahoo.com

Thank you,

Mr. Jason Mark Young, MS

Beyond Coping: Mastering The Joyful Art Of Caregiving

I will soon be presenting within a virtual event entitled, “Beyond Coping:  Mastering The Joyful Art Of Caregiving”.

Ten informative teachers, including myself, have come together to provide you with education and advice and to share their collective wisdom and experience, with a focus on helping you to be more joyful in your care giving experience.

Attendance is FREE of charge. And you can listen from the comfort of your home or office and by using your telephone line or your computer.

Please learn more about the telesummit and sign up by clicking here:  “Beyond Coping:  Mastering The Joyful Art Of Caregiving”

Parent Diagnosed with Alzheimer’s – Where Do I Start?

On 7/22/09, I was interviewed by Dale Carter on BlogTalkRadio.  Please listen to the show: