Be a “difference maker”

James C. Denneny III, MD
AAO-HNS/F EVP/CEOEvery month seems to begin and end with both new and recycled aggravations and impediments to practicing the type of medicine we envisioned when we entered the profession. Additional requirements and rules to practice piled on by hospitals, insurers, and licensing boards continue to add to frustrations as we are pushed further away from our patients. There is no question that these same patients can sense the building weariness and dissatisfaction in the healthcare delivery system. Patients themselves are suffering from burnout as they are forced to deal with the increasing complexity of our current healthcare system.

Most of my time as EVP/CEO of the Academy is spent identifying the current issues, predicting future directions, and marshaling both resources and support to positively affect the forces undermining our ability to give patients the best care possible. Even though we have experienced significant successes, the exasperation and disappointment our members and their patients feel when we fail to resolve illogical and territorial policies that exist “just because” is palpable.

Then, out of nowhere, a fortuitous string of events that strengthens one’s resolve helps get you back on track. I recently was blessed to experience two such events that validated the need to continue the aggressive pursuit of making things right for patients.

My current practice situation allows me the freedom to spend extended time with patients. This is fortunate, since most of my patients are seeing their fourth or fifth doctor trying to solve chronic problems such as cough, dizziness, and dysphagia. A recent patient who had seen physicians in four different specialties for problems with swallowing, chronic cough, hoarseness, and weight loss for the last nine months came in with their family seeking one final opinion before agreeing to a feeding tube. After a 30-minute conversation with the group and subsequent examination, it became clear that the current diagnosis was not the cause of the problem. Following the initiation of appropriate medical management, a full recovery ensued. I have received six letters from this patient and their family thanking me for taking the time to listen to the story and solve the problem, as well as offering their concern for my busy travel schedule. I can’t tell you how much these letters have buoyed my spirits.

I have also had the occasion to be on the other side of the relationship recently. An unexpected, serious medical condition of a family member allowed me to experience an uplifting, hopeful side of medicine that gives me great confidence that things will work out. The unselfishness of colleagues willing to assist us in finding the best possible care for this problem was remarkable. Starting with colleagues and strangers studying records and reading films on a weekend for a patient they have never seen, to our actual trip to Memphis, TN, everything was exemplary. The diagnostic acumen of the neurophthalmologist (Lauren Ditta, MD), neuroradiologist, and neurosurgeon (Frederick Boop, MD) was exceptional, but that’s not what stood out about the visit. At a time when anxiety was high and recommendations uncertain, the neuroradiologist we saw at Le Bonheur Children’s Hospital, Asim F. Choudhri, MD, was a “difference maker.” After a full day’s work, he spent an hour going over multiple MRIs with our family, considerably easing our minds. To top it off, he then drove us to our car at 8:30 pm so we wouldn’t have to walk. Really? I can assure you that we would not consider going anywhere else for follow-up, despite the travel requirements, based on our experience with the caring expertise displayed by these three physicians.

The Academy also strives to be a “difference maker.” We will be previewing a new patient information website in 2018. Our goal is to become a “trusted source” for patient-centric information presented in a fashion that is understandable by the lay public. With the proliferation of medical information available on the internet through multiple sites, it can be both difficult and frustrating for patients trying to separate “infomercial” type content from evidence-based recommendations. We will be upgrading our entire patient information portfolio as a part of this project. We will be looking for volunteers to participate in the production of the culturally sensitive, technology-enhanced materials that cover the breadth of the specialty.

Take the opportunity to be a “difference maker” whenever you can. I can assure you that the benefits you receive will at least equal those of your patients. We will continue to fight the daily battles, so you can focus on your patients and profession.