Tag: team

I am so lucky that I listened

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My patient just told me ” My other doctor said I am just going to have to get used to being fat. She has done everything.”

Umm what? Giving up on your patient? You have done everything? Really? Not according to what I’m seeing. Usually when I dive in and explore the issue, there are all kinds of stones still unturned. The last time I checked, the ONLY circumstance when you might even have a chance of giving up is when someone is dying of terminal cancer within days. Other than that, no excuses. You are still on the line to help. You are a doctor for chrissake.

I am one that tends to never give up myself. That is what I am actually here for, to help and give knowledgeable advice on the issue and how to try to solve it, not just to give up. Mind you, I have rules though. I make it clear to the patient from the beginning that whatever we are working on is a team effort. I make it clear that it will take effort from both of us. I try to empower them to be the captain of their own healthcare team and be an active participant. There will be no randomly missed appointments and non-compliance with reasonable expectations. I have to have at least that for us to work together for your benefit.

I get it, sometimes you have those patients that have hit rock bottom, are ready to quit and give up themselves. But, I am willing to bet that if you look deeply enough, you will be able to discover the reason why and help them get past it and move toward better health. It can be done folks. It really can. You giving up is not an option. I just can’t bear to hear that anymore.

Bottom line, I am right here, ready to listen, ready to problem solve, ready to be a part of your team. C’mon down and lets see what you need! I bet we can come up with something together!

Dr. Katz

Hey there doctors! Guess what? It’s actually a good thing when you have a knowledgeable patient interested in their health care!

It has come to my attention after being a patient A LOT lately, that for some doctors, having a patient who is knowledgeable, dares to ask a question, and is genuinely invested in their own healthcare is some kind of terrifying threat.

Huh? Why? Can anyone tell me why? To me, this makes no sense whatsoever. When I get that patient who asks questions and truly gives a crap about their own health care and wants to be involved, I personally feel like I hit the lottery! I am like O Happy Day! Let’s get you healed and healthier together. Let’s help make you the captain of your own healthcare team. Let’s surge you on to the path to wellness together!

The chances of success in this type of scenario are about a 100 times the chances if it’s not. When you have a patient that is willing to put the work in, is interested enough to ask the questions instead of just blindly following without understanding, that is like striking gold. That is awesome! That is the goal we should be trying to achieve! I just don’t understand why it doesn’t seem to be for most physicians.

But, knowing me. I have a few theories though and I would like to share them with you. Mind you these are just theories and I have no scientific documented proof, but I have had a hell of a lot of experience as a physician and as a patient and this is what I have seen.

I am worried that the physicians that seem so threatened by a patient that asks questions perhaps are just not confident enough in the care or the information that they are providing, or not providing as the case may be.

Well, this should never be the case. Be prepared at all times for questions and clarification. Know your patient so well that you can pre-anticipate what questions might be asked even before they are asked. Actually look at that chart before you enter the room. Anything you are unsure about? Look it up ahead of time and either be ready to talk about it or honestly admit that you don’t know,but are willing to help find someone who does.

It really is that easy sometimes. I get it. Not all conversations are easy. I am just saying that you have to put the pre work in to make things go as well as possible. Sometimes you are giving potentially horrendous news. There is nothing easy about that. It is not the patient’s job to reassure you, it is your job to reassure and support them. This news may make your day a lot tougher emotionally, but it may be changing their entire life all at once. It’s about the patient and your purpose is to help the patient so you gotta just pick up your bootstraps and do it or find another profession.

The bottom line is, I am not one of those threatened by patients being involved or asking questions. I welcome it with full on joy! Bring on them questions!

Dr. Katz

How to give bad news ” the right way.”..or what is the patient’s role in their own health care?

Ok what the heck does that mean? I am going to tell you what it means to me. I have had to give a lot of bad news lately. I have also had to receive a lot of bad news myself lately with all my cancer battle stuff.

Most of the news I have had to give has been heartbreaking because the scenario was scarily familiar: women who hadn’t had regular care in many years and finally made their way to me. I had to be the one to drop the verbal bomb on them about something that was probably either preventable or vastly more treatable with earlier detection and treatment that could have come with routine, regular care.

So, what is the best way to go about giving bad news? I feel like this is something that we are never really taught in a meaningful way in medical school. I have not seen any significant study proven data that describe exactly how to do it. Most of the techniques that I use have come from my own experiences as a patient and the experiences that I have with my patients.

The first thing I would like to emphasize is that you really need to put the time in to know your patient. You need to know much more than the details of their history and their diagnosis. You need to take the time to know them as a person. You need to have an appreciation of their life situation and the availability, if any, of any family or friend support. You have to at least have an idea of what they are ready to handle and digest in terms of information about their diagnosis. Not every person is the same. Not every person is ready to hear the complete blunt truth all at once. Some need to hear things in phases and parts. Some need to hear it all at once. You need to figure out which is which.

Please, do not attempt to commiserate with the patient by saying things like ” I totally know how you feel…or I completely understand what you are going through.” There is a 99 percent chance that that is not true, unless you literally have gone through the exact same thing. It almost is kind of an insult to the patient and minimizes what they are going through without you meaning to. It is much better to say something like…”Of course I can’t possibly fully understand what you are going through, but I am going to do my best to help you get through it. or…”.I know this news is hitting you very hard right now, but I want you to take a minute to take it in and let me help you figure out what direction to go next.”

It is essential to get the patient actively involved in their care. This sounds obvious, but you would be amazed at how often a patient gets almost immediately lost in the shuffle of the “team process” without actually being able to be the captain of their own team. This is absolutely crucial. This is the very first stage of empowerment for the patient that has to be initiated as soon as possible. This is the beginning of the way to help them see their way through their diagnosis. I am always puzzled at doctors that are wary of patients that are knowledgeable and want to be involved in their care. I personally feel that this is the ultimate blessing and one of the best probability indicators of success and survival. We physicians should never be unnerved by this. We as physicians need to realize that our roles are as team members and advisors with experience, never patriarchal dictators of patient care regardless of patient input.

Just some food for thought guys.

Dr. Katz

Wow It has been 4 Months Since I’ve written!

My last post was actually in january 2024, fresh into the throws of my recent primary CNS Lymphoma diagnosis with a brain filled with tumor, mush, and swelling to the point of almost being unrecognizable as a brain by the time I had my brain surgery to get a cell sample. Fortunately, I was in the right place at the right time because I started crumpling like a piece of paper. It was like everything was spiraling out of control very fast. Suddenly I didn’t know my name or where i was or my birthdate. I just sadly shook my head at the neurosurgery check in lady. Thank goodness my husband was with me. He helped fill in the gaps. I underwent my brain surgery and slipped into an encephalopathic coma complete with seizure, swelling and the whole nine yards. My poor husband had to watch all this develop right before his eyes. He stayed with me the whole time I was in the coma, holding my hand, singing to me, trying to reach the me inside unconscious me any way he could. He didn’t give up! He kept telling everybody that they just didn’t understand. This was the fiercest, most beautiful brain they had ever seen and they had to save it!

Well, thank goodness we got there when we did. Once we started treating my seizures and started decreasing my swelling with steroids, voila I woke up days later! Awesome! However I am told that I was not exactly me but more of a smiling simpleton, picking at my brain surgery incisions. Oh for heaven sake. Things continued to improve in the icu and then I got to be transferred to rehab to relearn how to walk with balance properly ( Dang that brain is in charge of a lot).

Then after I finished rehab it was time to get a picc then a port placed and get the chemo started! This still didn’t happen until January but I was grateful it was happening at all. Now fast forward to May now. Weekly high intense chemo cycles for a total of 8 cycles, plus oral chemo. week in the hospital at a time. You see the particular chemo I was getting this time had to be cleared enough out of the body for me to go home without exposing somebody. Yikes.

Now the 8 cycles are over and my brain looks like a real brain again and I actually feel fully functional mental status wise but still get exhausted. I am so grateful just to be able to open my eyes in the morning. I was ready to be done with all this but the thing is, you are never really all the way done. I still have follow up to do for my first cancer and I always will but I am down with that! Let’s keep vigilant! Let’s keep paying attention. Let’s keep self-advocating.

The real truth of the matter is that I have had two totally different lymphomas in 3 years. That is not ok and a brisk pace to keep up. Would I keep doing it if I had to? Hell ya, I got too much to live for. But if there is an option out there that would possibly give me more time off cancer? Yes there is. This is the stem cell transplant I was talking about. First steps are shooting yourself full of granulocyte colony stimulating factors to make your lymph and bone marrow cells multiple like an army within! Thats a lot of hard work creating your own army. There are significant aches and pains involved, but I got through it. When the day came to retrieve the stem cells, I broke a record. The process was supposed to take like 8 hours and generate 3 or 4 million cells. Well it took me like 4 hours and I kicked out 11 million. They actually had to stop me early! WOW!

Now you take a few days off to rest and get admitted back to the hospital for cannon ball marrow ablating chemo for 8 straight days to zap you down to nothing. Rest again and put the health stem cells back. Let’s hope this works! I’ll let ya know.

Be well

Dr. Katz

Thank the lord for my awesome staff!

As you may or may not know, I have taken on a lot of stuff lately. In the last few years, I beat cancer, nursed my husband back to health after his heart attack, worked without pay, wrote some books ( buy some will ya?), became my own office manager, became my husband’s office manager, fired staff, hired staff, completely switched billing companies, expanded social media, started a lecture series, started a chemo support group…..whew. I think the list keeps going even after that. It’s a lot. I get it. Most people who foolishly ask me how’s it goin, may or may not want to actually know, but I tell them anyway! Then they get a little stunned. They wonder how I am not an overwhelmed hot mess. I tell them no, I’m actually not. I am enjoying it. Ok, that sounds crazy right? But let’s look at it this way. That is a ton of stuff for one person, I agree, but none of it is bad stuff. My uber positive spin on life right now makes me respond,” ya know, I think it’s the universe telling me that I am finally health enough to take on even more stuff!” Then they give me a weird look and kind of nervously laugh. I go on to explain that I believe in signs and a purpose to just about everything. Whether that thinking is religiously based, spiritually based, or magic based, it doesn’t matter. It only matters if it gets you motivated. Well all these things that have happened have only strengthened my sense of purpose. I like taking care of things. I love how the whole culture of my office has changed. Everyone is happy. Everyone falls over themselves to help each other. We all look forward to going to work every day. I couldn’t possibly have it better and I’m saying that even though we are still regaining economic strength with the new billing company and I am not consistently getting paid. I am there because I love it and I appreciate my whole work gang! They pay attention. They actually watch me for signs of burnout like I watch them…unprompted! It’s amazing. I wanna keep that going as long as I can. It’s a team effort. Being a good leader also means recognizing the skills of everyone around you. I only hope everyone can have a work environment like mine. You can, but you gotta work for it.

Dr. Katz

Taking Ownership

How many times have we all waited for someone to take care of something for us? How many times have we been stalled in a work project, waiting for someone to finish their part? The frustration and loss of time in doing this makes no sense. I say forget it! Let’s try a different strategy. It’s time to take ownership.

So, what does that mean? According to the Harvard Business Review, one of the most egregious momentum killers is waiting for someone else to act, take initiative, or take charge. Most of the time, no one is coming. So, why do we do it? If help isn’t coming, let’s liberate ourselves and take responsibility and move forward. Start believing in yourself as an individual and take stock of the fact that it is, in fact, your responsibility for the quality and timeliness of an outcome. This applies even when you are working with others. It doesn’t mean that you are always in charge of everything. It doesn’t mean that you shouldn’t collaborate with anyone. It just means that you take ownership of your part and the results.

The same article in the Harvard Business Review went on to discuss that there are a couple of basic things to understand about taking ownership. First, I think we need to be able to tell the difference between fault and responsibility. When we finger point at others or at ourselves when something is not getting done, the perception of fault gets in the way of taking ownership of a difficult problem. Then, the problem still doesn’t get solved. Get rid of the blame game and we will all be more successful. Second, taking ownership frees us up to move toward getting results or finishing a project. Last, we can actually help others not just ourselves by taking ownership. Sounds like a win win to me.

The bottom line is, taking ownership/accountability/responsibility for your part can only help yourself, others, and the project move forward. Blame and finger pointing does nothing but waste time and energy. Don’t waste the energy. Put your big girl panties on, take responsibility and forge ahead!