Author: noorali

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I SAY, I SAY: Change is inevitable

My friend Bill – not his real name – says what is happening to him in his personal life is similar to what is happening in the health-care system. Now he regrets he did not anticipate or prepare for these changes.

Changes in life are inevitable. Sometimes they are good, sometimes not so good. Sometimes they come suddenly, sometimes slowly. But things change all the time. What counts is how we anticipate, plan for and handle change.

Let us look at Bill’s true-life story.

Three years ago, Bill celebrated his 50th birthday. He was married with two children, a boy, nine, and a girl, seven. Bill was at the peak of his practice as a surgical specialist. He had plans to retire at 55. In fact, his financial advisor had made plans for Bill’s retirement in year 2002.

Bill’s main consideration was his children. They were very young and he wanted to put some money away for their education. He felt confident that with another five years of hard work he would be home free.

Well, people or nature can sabotage even the best-laid plans. That is what happened to Bill. A few months after his 50th birthday, he developed health problems. This put a significant scare in his head and he realized nobody is guaranteed immortality in this world – young or old.

Bill had to make significant changes in his practice, resulting in a major financial loss. His disability insurance did not kick in, as he was physically thought to be well enough to work. Mentally, he felt very insecure. He wanted to reduce the risk factors in his life to prevent deterioration in his health. Cutting down on stressful work was one way to do it.

Three years have gone by. Mentally and physically Bill has not done badly. He has curtailed his expenses (cutbacks) and managed to survive with limited income. But his children are now 12 and 10. Their needs and expectations keep mounting according to market popularity (peer pressure).

This is what is happening in the health-care system. The governments and health authorities may survive or limp along with cutbacks and limited resources, but people’s needs and expectations do not diminish. In fact they increase as new ways of diagnosis and treatment enter the market.

As we know, this is where governments have failed. They have no political will to change people’s expectations in a changing environment of “fiscal responsibility.” The burden falls on the physicians who are “independent practitioners” but still have the responsibility to do governments’ dirty job of rationing health care.

How can we be “independent practitioners” when we are controlled by two masters – the governments who pay the piper and patients who call the tune?

Physicians are angry and totally demoralized, as we did not anticipate the speed or prepare for the changes in the health-care system. These changes have been coming fast. And there is promise of more to come. But we – and our leaders – continue to fight change instead of becoming part of it.

Like stress, change is part of our lives. It is not going to go away. The question is: How do we plan to handle it?

Start reading the preview of my book A Doctor's Journey for free on Amazon. Available on Kindle for $2.99!

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Changing Lifestyle

“Rome was not built in a day and sometimes it’s the smallest decisions that can pretty much change our life.”

This applies to me quite well. My surgical mentality makes me a very impatient person. When I see a problem, I want to fix it quickly and get to the next one! My son thinks that’s cool!

But life outside operating room is different. My son is too young to know that. But you and I know how difficult it is to make changes in life. Quite often these changes have to do with our habits and lifestyle that have been part of our life for many years. Then comes the month of December and all hell lets loose. By the time we finish the New Year’s eve party, we are deep into guilt and self-mortification.

Next morning, we decide to change our whole lifestyle. We think it can be done overnight. After a well-intentioned weekend, we open the newspaper on Monday morning. Experts are already out there predicting failure. They feel we are half-hearted, poorly organized individuals whose actions fall far short of the intentions.

So, it is left to us to prove them wrong. How can we do that?

Lesson No.1: Be prepared. Most people’s resolutions are about lifestyle changes: quit smoking, lose weight, exercise regularly, eat healthy, spend more time with family, learn to say no to excessive demand on time and many more. None of these can be done in isolation. So when we try to make one change, we have to be prepared to make changes in many more areas then we expect.

Lesson No.2: Know the benefits. We should have convincing reasons to change from the current situation. Take a moment and write down the advantages and disadvantages of the proposed change. If there are no obvious benefits then don’t do it.

Lesson No.3: Look at the ladder. Once the decision is made to go ahead with the proposed change, then make a list of the steps required to implement the change. This will require help and understanding from family, friends, and most important your co-workers.

Lesson No.4: Join a group. Ask yourself if you are going to do this on your own or join a group. It is easier to do it in a group – may be formal or informal. A little bit of competition and monitoring helps achieve the desired results and keeps the motivation going – if he can do it, so can I.

Lesson No. 5: Be patient. Rome was not built in a day and sometimes it is the smallest decisions that can pretty much change our life! Say it 10 times a day and keep smiling! Pick reasonable targets and be positive. Think of what you want – NOT what you don’t want.

The other day, I was looking at the book “Born to Win”. The back cover says, “Every person has the potential to be a winner: to be an authentic, alive, responsive, fulfilled human being.” You are that person. Go ahead. Plan it and do it!

Start reading the preview of my book A Doctor's Journey for free on Amazon. Available on Kindle for $2.99!

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ELMOS

What’s going to keep us healthy in the next millennium? Is it going to be science and technology or ELMOS?

ELMOS is what I call the basic tenants of good health. If you take care of ELMOS then you know you have taken care of yourself. There is no better care than self-care.

ELMOS stands for: Exercise, Laughter, Meditation, Organic Healthy Food and Stress Management. Many of the modern day killers (stress, heart disease, accidents, and cancer) will be taken care of if we take care of ELMOS.

What about our genes? May be genetic engineering will take care of that. But, there are no guarantees in life! What we can do is build a good foundation for good health. I believe, ELMOS is that foundation.

EXERCISE. A study published in 1994, showed that regular exercise is important for health and reduces the risks of chronic diseases. The US Centers for Disease Control and Prevention and the American College of Sports Medicine encourage 30 minutes of moderately intense physical activity every day. But it is estimated that only less than half the adults in North America exercise regularly. We need to do more.

LAUGHTER. There is a lot of truth in the old saying – laughter is the best medicine. The happier you are the better you feel. Ashley Montagu has written about the origin of laughter. She says the only animal that speaks is the only animal that laughs. Laughter is an expression of joy and can be infectious. This is one infection worth spreading!

Montagu says: It is well known that laughter has a tonic effect on the mind and body, suffusing the body with a feeling of well-being that few other activities are able to provide, refreshing, relieving, enlivening, and involving the whole body in its “happy convulsion.”

MEDITATION. The practice of meditation has occurred worldwide since ancient times, says Encyclopedia Britannica. There are numerous techniques of meditation – religious or otherwise. It is considered holistic and humane. Medical and psychological studies have shown that meditation is effective to varying degrees in the symptomatic control of migraine headache, hypertension, and other conditions. It helps in the purification of body, mind, and soul.

ORGANIC HEALTHY FOOD. The Environmental Magazine says: Of the 300 pesticides approved by the federal government, 73 (including some of the most frequently used) are “probable” or “possible” carcinogens (substances which cause cancer). There is also a risk to nervous system damage. What about the balanced healthy diet?

The Canadian Cancer Society, the Heart and Stroke Foundation of Canada, and the Canadian Produce Marketing Association have recently launched a campaign to encourage Canadians to eat at least five servings of vegetables and fruit every day. This will help “prevent thousands of future cases of cancer”.

STRESS MANAGEMENT. I did not use the work “prevention”. As Newsweek magazine says: Living a stress-free life is not a reasonable goal. The goal is to deal with it actively and effectively. Some of the coping mechanisms are: exercise, meditation, relaxation and massage therapy. Learn to philosophize and rationalize issues. It is good for the soul.

I believe, ELMOS will save many painful moments in our lives in the next millennium. But we need to find time and make an effort. Nobody can help us with that. We have to set our own priorities.

I wish you and your family a happy, healthy and prosperous thousand years!

Start reading the preview of my book A Doctor's Journey for free on Amazon. Available on Kindle for $2.99!

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Health Care System

Once upon a time, the sick and the weak were taken care of in monasteries. This usually involved faith healing by means of prayers, penance, supplication to suitable saints, and contact with sacred relics, says Dr. Knut Haeger in the Illustrated History of Surgery.

Priests and monks practiced medicine without any insight into human anatomy and physiology, says Dr. Haeger.

Monasteries stimulated the development of hospitals. The oldest hospitals were founded in Sri Lanka around 500 BC and India had effective hospitals by 260 BC.

Much has happened since then. Now we have modern hospitals in almost every town and city. People are living longer. Most of them feel good about themselves.

About 60 percent of the people in our region and provincially report that they are in excellent or very good health. About 80 percent feel that health care services are easily accessible. About 90 percent feel that the quality of services received is excellent or good. Only 5 percent reported failure to receive needed care. With results like this one would expect that everything is good to excellent in the health care system.

But we know it is not. In the real world things are different. I get up in the morning and open my newspaper. The headline says: Hospital strapped for beds. I look at the third page. It carries a story of a cancer patient who cannot get an MRI.

I look at the editorial page. The editor blasts the government for ignoring the health needs of the people. Then there is a letter to the editor from an angry daughter who feels that her mother should not have been discharged from the hospital as she lives alone. I look at the ticked off column. A man is angry because he had to wait in the emergency department for four hours before he could see a doctor.

As I drive to work, I wonder if there is a perfect health care system in the world? Having lived in four continents I should know the answer. No.

In the last century or the millennium has there been a system that has worked for a particular country? No.

Then whom are we trying to fool? Why the morale of the people who use and deliver the services is so low?

Because the government promises too much to the people and expects the health authorities and front line caregivers to deliver the goods- first class -within a confined budget. How can we be responsive to people’s changing needs when the cost is prohibitive?

It is time people know the truth. But the “political cowardice” and the “democratic election process” inhibit such honesty. In the process, the system is burning out people who have to deliver the goods – the health care professionals.

In an article titled “Assessing Processes and Outcomes of Medical Care”, Dr. David Naylor, Professor of Medicine, University of Ontario says: Here then is a challenge for us all. Canada’s public health care systems are in the throes of a difficult transition. When the health system is squeezed, the professionals in it are squeezed. And when the system is restructured, our lives are disrupted. Frustration mounts, and at the time when Canadians need clinical leadership, there is a risk that it will recede as alienated practitioners start worrying more about the diminishing quality of their lives, and less about the diminishing quality of the health-care system.

I believe it is time the health care professionals and the patients unite to save the system for the next millennium – for our children and grandchildren. This is too important a business to be left to the politicians!

Start reading the preview of my book A Doctor's Journey for free on Amazon. Available on Kindle for $2.99!