Got some exciting stuff going on here at Mayo!! I've been busy in our new block with immunology and pathology. It's a great time, and in pathology we are really starting to think like Doctors! We do differential diagnosis assignments each week with a clinical vignette and pathology slides to assess what happened to the patient and why they ended up dying. Although we are still growing in our medical knowledge, it's fun to think through the systemic processes and begin to understand a little bit how we would "work up" a patient and begin to understand their underlying disease process. We will have to do this when on our family medicine rotation in third year, so it's great practice for us now as "newbies" to get to do this and receive feedback from our TAs who are third years!
In the afternoons, we are in Basic Doctoring. Right now we are practicing the physical exam, and we will have a cumulative test on it on March 1st. We'll have to do a standardized patient exam with a stranger in the simulation center of Mayo and be graded by consultants that watch us on video in another room!
Here's a run through of all the components we are responsible for:
I have to put a plug in for Mayo, as recently I filled out a survey and got this free book. It's so cool! It goes through all of the common spices and home remedies and gives it a "traffic light" approval. So Green is a go ahead, yellow is a cautious, red is NO GO. You can buy used copies on Amazon, or if you want one I can get it for you and ship it! Just send me a note! They are $29.95 in the Mayo Store here at the clinic. I think it's pretty neat. We learn in medical school that it is important to mesh the ideas of the patient with the ideas of the doctor. It's called shared-decision making, and I'm sure you have had examples where this doesn't occur! Has the doctor ever told you to do something very authoritatively without considering your opinions or home remedies or traditions? I know I have certainly had that experience.
Our practice is that we assess what the patients beliefs and traditions are and use them in our treatment plan to ensure that the patient is on board and will follow through with the prescribed treatment. If the treatment doesn't fit into your life well, there's a high likelihood you won't want to follow through with it or be committed to the doctor's orders!
Basically, in normal situations of administration, we take physicians our of their environment and try to turn them into business people, but that isn't always effective! Instead, we need to focus on what the physician knows best and that is the patient! Value in healthcare SHOULD be defined by the patient and what they are willing to spend on a treatment when an alternative, less-expensive treatment is readily available. This is called the "BRAND VALUE."
CVO's need to be cognizant of the brand development of an organization, the brand management, and brand loyalty by patients. Are you presenting your practice the best you can and are your patients happy and willing to go to your practice? It's all about developing the patient experience and understanding the intersection of the psychology of illness with the patient experience. We also need to be cognizant of the social psychology of our clinical care strategies. but MOST OF ALL: THE NEEDS OF THE PATIENT COME FIRST.
I think we can apply the values of a CVO to any organization or practice, and it's important to identify your practice's values and continue to assess them over time to make sure they are providing your target population the greatest good!
Sorry, this might get a bit preachy, but I just wanted to share a tidbit of my time with God today.
As a part of my women's bible study we are going through the book Becoming a Woman of Prayer. I fundamentally disagree with a few things in this text, but for the most part it's a wonderful delve into what it means to be a woman of prayer (totally could be a man of prayer as well).
One of the scriptures it recommended for intercessory prayer (praying for others) was John 17, as Jesus prays for the himself, for his disciples, and for the world. It's here if you want to read it.
It's lovely, truly, but something else stood out for me. It's when Jesus is praying an intercessory prayer for his disciples.
"13 But now I am coming to you, and these things I speak in the world, that they may have my joy fulfilled in themselves. 14 I have given them your word, and the world has hated them because they are not of the world, just as I am not of the world. 15 I do not ask that you take them out of the world, but that you keep them from the evil one.[a] 16 They are not of the world, just as I am not of the world. 17 Sanctify them[b] in the truth; your word is truth. 18 As you sent me into the world, so I have sent them into the world. 19 And for their sake I consecrate myself,[c] that they also may be sanctified[d] in truth."
A few years ago, I heard about a woman who lived in inner city Detroit and was working with an orphanage that was affiliated with a very poor and urban church. Every day she would hear gun shots, she would barricade her door, should someone try to force entry, and she often didn't sleep due to the noise of the streets and the neighborhood surrounding her. I thought to myself at the time, how can this woman maintain her faith amidst the darkest, and most brutal parts of the city? How can she continue to witness of Christ's love and mercy for his people when all she saw was hurt, destruction, and violence?
This scripture, almost 6 years later, has answered my questions.
These verses are a message to us, that the Lord wishes the greatest good for us. Often as Christians we hear things about leaving the destruction of the earthly world, and to escape and barricade ourselves away from the evil and sin that surrounds us daily. I've heard people tell me to escape from the World and surround yourself only with God's children, should you be tempted by sin. This has some truth to it. But this leaves the world without light, without hope, and without truth. I believe this is Jesus' desire - that we be immersed in the world and that God gives us the strength each day to be his Children and his disciples in the dark world. Because he is in us and that means we are not of this world, just as Jesus spoke of his disciples. HOW AWESOME.
Jesus prays that his disciples not be contaminated by the world, and that they be sanctified by the truth, which is the Word. How powerful is it that Jesus has so much faith in his disciples that he likens them to him? Now, how powerful is it that Jesus has that same faith in each of us?
A few scriptures that came to mind as I was sorting through this:
Proverbs 15:3 The eyes of the Lord are in every place, watching the evil and the Good.
Psalms 121:8 The Lord will guard your going out and our coming in, from this time forth and forever.
I hope this is applicable to your life, as much as it was for mine.
Happy new Year to everyone! Wow what a year it was last year. I started the year not knowing where the next chapter of my life would take me, and even if I would get into medical school. I got into one of the best medical schools in the country (only the Lord knows how), and pursued my dream to be a physician by moving to Rochester, Minnesota.
When they say it's cold in Rochester, it's really not a joke. Today was -15 degrees and the high was -3. The windchill is what really does you in, as it was -35 today, and it really burns!!! The moment I go outside and the wind hits my face, I feel my frontal sinuses freeze. But good thing I only live a block and a half to the entrance of the Mayo "Subway" or system of underground tunnels.
We are currently in Pathology and Immunology at school. It's a lot of great fun, and it's kind of the point where we start to actually feel like Doctors in Training. We are busy every morning learning different cases and pathological slides, and in the afternoons we are learning and practicing our physical exam. Soon we will get to do it on a real patient (but it's graded......)! As I sit here drinking the best hot cocoa in the world (from Aldi - sea salted caramel), I am quite reflective on how much I have learned since entering medical school. If it is any sign of how much I will learn in the years to come, I am so insanely excited and scared. How will my brain be able to fit all that knowledge in!?!?!?
Tomorrow, MLK DAY we have off, but don't worry. I have a packed schedule. I have to go to the chiropractor (oh yeah. I broke my head...more later), work on some differential diagnoses, and go to a facilitative selective training (more on that later too).
So. Right. I was playing soccer.....which was probably a bad idea in the first place given my history of traumatic brain injury.....and I got CREAMED by this 18 year old kid. He toppled over me and the back of my skull bounced off the concrete. It was not a pretty sight. I immediately had visual changes (black dots, little vision in my right eye, and blurriness), so I asked my classmate Kevin to drive me to the ER. I think he initially did it so he could drive my new car! ;) (Just kidding, Kevin).
My teammates/classmates stayed with me in the ER for most of the night. It was so nice of them!! They ended up just giving me heavy duty pain killers and sending me home to sleep. So I slept for a good four days, but my head remains painful, and I am still getting over the nausea, vomiting, and dizziness a week later that comes with severe concussions. I think the worst part about this time (thankfully not as bad as my TBI) is probably the visual changes. It's not reassuring to have wavy vision, rainbows, auras, etc. I hope it eventually goes away.
The only other excitement here (which, I don't really need excitement)...was that I got a giant whiteboard!!! Now I can write all kinds of things on it. I prefer to study at home with Purkinje, especially because my bedtime is around 8:30pm and I get up around 4:30-5:30am, so it's a lot easier for me to study at home. I have really been enjoying using the different colored markers and playing around while doing my differential diagnoses.
Here's a snapshot of it:
I hope you have a great week! Anything you want to hear about? Let me know here.
I have had some requests about ways to study in med school, so that will be coming up!!
I'm also finishing up some really awesome chairs! So I'll have them up and their transformation soon!
M3 at Mayo Clinic School of Medicine