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Feb 4, 2018 11:43PM
Feb 5, 2018 02:27AM
Yes, but my focus was different. It was women health and the operating theatre.
It still is mostly.
Mercifully under the Australian Anaesthetic College guidelines there is no described need to be what I call "death specific" WHEN risks are evident and treatment choices limited. Plainly put, you do not have to tell a patient that has lost half of their blood volume that they may die - it is sufficient to say your life is at risk because of bleeding and these are the steps that need implementing. Assuming the patient is conscious and able to make decisions about own health, in my experience you are given one of three responses:
- those who don't want to talk more, depending on treatmenttime pressure you might give another opportunity, a little later
- those who want to ask but are shy/fearful/traditional - usually they look down and say they understand but pause - waiting for you to say - is there anything at all you want to know more about/ask - opens up a discussion
- those who plain ask - am I going to die? followed by " I want you to do this" and it's not always what you might assume.
I always hated labels - for one, sooner or later you are proven wrong.
As to breast cancer - I think the whole women's health in Australia is heavily under represented.
I wouldn't wait for change to come from medical ranks - we are wildly disorganised individuals on some levels - business models of any kind are not taught in medical school and perhaps they should be.
The majority of hospitals are lead by accountants or lawyers, occasionally nursing staff with MBA - and budgets have a huge role. I could go on a little but it's outside this thread scope.
Can we get it back? Old fashion Medicine? Do we want to?? Ahh I think that train has gone but we can perhaps learn to communicate better, more efficiently with patients AND among ourselves AND with other health professionals, government officials, pharmacetical companies, research fund raising bodies.
That would take a shift from the traditional concept of measuring health care delivery of a good/great doctor (individual compentence) treating you to a good/great team treating (team compentence) you.The caviat (this work is from Canada) is that failing communication (for a variety of factors none of which may be directly related to individual compentence - time,human, geographical, technology - therefore no point just fixing one individual) you can have competent individuals making up an incompetent team.
I am done for a while I think...
Hope your back is better. I love the country.
Well wishes to all,
8/5/2016, DCIS/IDC, Left, 4cm, Stage IIB, Grade 2, 1/13 nodes, ER+/PR+, HER2-
8/11/2016 Lymph node removal: Underarm/Axillary; Mastectomy: Left; Prophylactic ovary removal
9/11/2016 AC + T (Taxol)
2/21/2017 External: Lymph nodes, Chest wall