In the classic rat sleep deprivation trials, total sleep deprivation ended up killing the rats in 11-32 days. When the researchers deprived the rats of REM sleep, or commonly known as “dreaming sleep,” the rats also died, although they did survive for a longer time period, 16-54 days. Nevertheless, sleep deprivation is very detrimental, and when I was training as a sleep specialist, I learned about myriad health problems when people become sleep deprived.

So, when patients are admitted to the hospital, why do we wake them up in the early morning to draw blood tests? Yale University researchers studied this, and they found that nearly 40% of laboratory studies occurred between 4:00 AM and 6:59 AM:

The traditional thinking behind this is that, by the time the physicians and APPs come in to see their patients in the morning, usually at 7:00 AM, the blood tests are ready for them, and they can act on the findings of those blood tests to help care for the patients.

Yet, this begs the question: do we really need to get blood tests that early in the morning? Would care suffer significantly if those blood tests were drawn at, say, 8:00 AM? There should be enough time to act on any abnormal test results in the morning and before morning rounds. At my hospital, we round at 10:00 AM, and so if blood tests were drawn at 8:00 AM, they should be back by the time I round with the rest of the team.

As far as I can remember – and into today – “AM Labs” are usually drawn at 4:00 or 5:00 AM by default or even tradition. Unless the patient is comatose in the ICU, getting a blood test at 4:00 or 5:00 AM can disrupt the sleep of our patients, which can be very detrimental and can hinder their recovery from illness.

It can also precipitate delirium in our patients due to the sleep deprivation, the effects of which can also be very detrimental to the recovery of our patients. Moreover, it can also disrupt the sleep of the clinicians caring for those patients at night, who have to be awakened also at 4:30 or 5:00 AM to receive notification of critical results and act on them. This sleep disruption can also affect clinician well-being and burnout.

Good sleep is often the elusive treasure of a hospital stay. Many clinicians chuckle when they hear this, but it really is no laughing matter. It may be time to rethink the necessity of getting blood tests so early in the morning, so that our patients can actually get a good night’s sleep and be well on their way to a good recovery from illness.

The post Are Early Morning Laboratory Studies Really Necessary in Hospitalized Patients? appeared first on Medika Life.

But times change, which means what was usual previously may need to be updated to meet the spirit and needs of the times and, incidentally, not to swear by Roman or Greek gods/goddesses. The burning question facing medical education today is how best to revise the oath that some find anathema. If medicine is anything, it is based on philosophy and science when it comes to making potentially life-changing decisions for patients.

How does the oath meet the needs of women’s healthcare when a life is in danger if a therapeutic abortion is not performed? The whole concept of “harm” comes into direct conflict with the oath. Where is the harm and which is the greater harm?

Does the oath, as it stands, still have relevance in a world decidedly different from the one in which it was written, or are we still being held to standards set at that time?

The question is roiling medical school administrators and students alike who must take the oath. And this is not an insignificant instance of a simple ceremonial change; it involves careers and issues of life and death. It should be noted that neither the American Medical Association nor the American Association of Medical Colleges requires an oath.

In 2015, a survey of 111 medical schools in the United States and Canada took part in a survey of commencements and the oaths that were taken then and at white coat ceremonies. The results show that more than half of these ceremonies did not use the original Hippocratic text but some variant of it, which was unique to the school and to those students. Three elements were found to be present in all the oaths: respecting confidentialities, avoiding harm, and upholding the profession’s integrity.

In 1964 Dr. Louis Lasagna prepared “A Modern Oath” which addressed many of the same issues found in the Declaration of Geneva first published in 1948 and then revised in 2017.

Some schools have used the updated version of The Declaration of Geneva that addresses a number of key ethical parameters relating to the patient-physician relationship, medical confidentiality, respect for teachers and colleagues, and other issues.

The revised declaration of Geneva carries pledges to:

1) consecrate their life to the service of humanity,

2) respect for teachers and showing gratitude,

3) practicing medicine with conscience and dignity,

4) the health of the patient is to be their first consideration,

5) secrets confided to them are respected even after a patient’s death,

6) maintaining the honor and noble traditions of medicine,

7) not permitting considerations of age, disease or disability, creed, ethnic origin, gender, nationality, political affiliation, race, sexual orientation, social standing or other factors to intervene in the provision of medical services,

8) respect for human life

9) not using their medical knowledge in violation of human rights or civil liberties

Social norms and concerns are now a part of these oaths and cover serious issues facing anyone in medicine today. The past is revered, but the present and future are also given their due in oaths being written by students today. There is no longer the mention of religious obedience in the oath and bias and discrimination have been addressed as well.

Ethical issues remain the province of the medical practitioner and are in flux with changes that will be encountered. Dramatic advances in technology will bring new, unexpected demands of physicians and other in healthcare. Flexibility of the oath would appear to be its abiding factor with regard to this future shift.

The post Old Medical Oath Needs Refresh From the Original Hippocratic Version appeared first on Medika Life.

The power of the painting is the gaze of the doctor on his patient. Now is the place, the time, the person – he has no other thoughts or concerns except to assist her back to health if he possibly can. We do not know the medical problem, but we can infer it is serious. And we do not know the outcome, although there may be a clue because through the window comes a faint ray of light.

I did not fully appreciate the implications of this work of art when I first received it, but I came to understand that this physician was a healer. He had listened; he was nonjudgmental; he had earned trust. He has done his best but understood that he alone would not be her cause of cure should a cure ensue. He understands that he is but a humble person entrusted with the most important of all missions – to assist others in finding health. He has done his best and, in doing so, exemplifies the characteristics of a healer.

My maternal grandfather, Leonard McClintock, MD., was a general practitioner in New York state. He graduated from Albany Medical School in 1898. He set up his practice in what was then a small town on the Hudson River, Beacon, N.Y. He built a room on the side of their home to serve as his office and used the large wraparound front porch as the waiting room. There were no appointments; you came and sat on the porch until it was your turn. Office hours lasted until the last patient had been seen. 

Initially, there was no hospital, and he cared for all patients in the office or at home, although later in his career, he helped to establish a hospital directly across the street. In his day, a physician had relatively few tools to treat someone, so the skill was to make a diagnosis and inform the patient and the family what the situation was and what the course of that illness would probably be. Yes, he could do some things, including treating pain with morphine, removing an inflamed appendix, sewing up lacerations, and delivering babies much more safely than could have been done without the assistance of a trained clinician. 

But during the course of his practice, which ended with his death in 1936, medicine began to change toward a much more scientific basis. To a large degree, this was propelled by the influence of Johns Hopkins University School of Medicine and Hospital in Baltimore, MD. Founded in the late 1800s, it instituted the concept that medicine was and should be a science. Therefore, Johns Hopkins would teach a science-based medical practice during four years of medical school. In addition, Hopkins established what we know today as the standard residency training program following medical school. 

This was a dramatic change in medical education and training and, as a result, dramatically changed the way physicians thought about medicine and patient care. During my grandfather’s practice, he began to see the beginnings of those changes. For example, insulin was discovered in the 1920s, and the first antibiotics in the 1930s. After his death and the completion of World War II, the National Institutes of Health began to develop, grow and place large sums of money across the country in various medical schools and within its own walls to conduct basic biomedical research. 

The result is that today our ability to repair, restore to function or replace an organ, tissue, or cell has moved ahead at a dramatic pace and will do so even more quickly in the coming years. Concurrently, the pharmaceutical industry also became scientific, resulting in a continual outpouring of new drugs that can relieve suffering, reverse harm and cure many diseases while extending our life span. In addition, with the advent of the science of genomics, it is increasingly possible to predict the onset of illness before it occurs and thereby create a preventive approach for the individual patient.

Soon we will have immediate access any time, any place to our medical records, which will be fully digitized, and the safety and quality of medical care will dramatically improve. All of this is because of the science base of medicine, which was introduced over 100 years ago.

Something else has happened, but it has not been appreciated. In the past, illnesses tended to be “acute,” meaning that they occurred, were treated, and got better, or the individual died. For example, if your child developed “strep throat,” the pediatrician gave an antibiotic, and it got better. If it was an inflamed gall bladder, then you were referred to a surgeon who operated, threw away the gallbladder, and you were cured. But today, most illness is chronic and complex as well. For example, if a person survives a heart attack, he may still have some damaged heart muscle and so develops heart failure. This will be with him for life and will need multiple treatments, many medications, probably multiple hospitalizations with an ICU stay or more, and might even get to the point of a heart transplant.

Now that is chronic, and that is complex! So it is also with diabetes, rheumatoid arthritis, many cancers, chronic lung disease, kidney failure, and many other diseases are frequently seen today.

This is a major shift and enormously impacts how we should [but mostly do not] organize the treatment of the patient and their disease, how we should [but mostly do not] organize the payment system for that care, how we should [but mostly do not] use technologies wisely for maintenance, and how we should [but mainly do not] assure quality and safety in patient care.

This is a profound change, but most of the “healthcare reform” approaches do not address the implications of this change to chronic, complex lifelong illnesses. Although aware of the change toward more and more chronic diseases, physicians also tend to want to preserve their current practice patterns developed over the years to handle acute illnesses, even though the current chronic, complex diseases require a different approach.

But in that same time frame of scientific advancement and the rising frequency of chronic illnesses, we also began to lose something in medicine. That loss is the genuine “connection” between the physician and the patient. Most of us feel we do not have enough time with our physician; the physician seems busy and distracted, often by the computer, and not able or willing to listen to our story in full. 

From the physician’s perspective, they feel that there is not enough time to spend with an individual patient; not enough time to learn about the family and the environment in which that patient lives, and therefore in which the patient’s disease has occurred; that there is not enough time to focus on preventive instructions or to even talk thoroughly about the plan for the care of a specific illness or problem. But all too much time is spent following mandates, filling out forms, often repeatedly, and then being paid by the insurer well under what the time and effort were worth. Physician burnout has reached epidemic proportions.

Today we need to preserve our newfound skills and techniques, drugs, and devices but also remember that patients are human and need empathy, caring, and attention, not just technology. Equally, providers need the ability (time) to give the care they were trained to provide, the care most wanted to give when they first decided on medicine as a career.

Unfortunately, rather than a true healthcare system, we currently have a dysfunctional American medical care delivery system. We need a healthcare system, but the cards are stacked against it. That said, it can be changed. Probably not by Congress, nor by the insurance companies but only by the unique interaction of doctors and patients demanding what is and could be the very best. Concurrently, one of the best ways to change the system is for companies to realize that they can secure better medical care for their employees while augmenting health and wellness, which will dramatically reduce the company’s and their employees’ costs. That is a win-win all around.

In later articles, I will outline further what patient and their doctors can do to improve care and what employers can do to create true healthcare for their employees.

The post Healthcare and Medical Care Are Not the Same – The Difference is Very Important appeared first on Medika Life.

Other colleagues called Poison Control, worried that she maybe ingested a toxic alcohol. I was incensed: “What are you talking about? She has sepsis! Get the antibiotics! Get the fluids!” I was on a tear in the Emergency Department.

I spoke to the Poison Control colleague (likely a physician in training), and he recommended I make sure she didn’t have any toxic alcohol ingestion (like wood alcohol or antifreeze) given how acidic her blood was. I rolled my eyes. “She has sepsis. I am absolutely positive.” He replied politely and said, “That is our recommendation. You can do what you want.”

I ordered a CT scan of her abdomen, fully expecting to see multiple abscesses like they were before. I was shocked: her abdomen was completely clean. I couldn’t believe my eyes. And while I was totally convinced it would be negative, a little voice deep down inside me said, “Maybe just check for an antifreeze level…just in case.” So, I ordered one.

The ethylene glycol (i.e., antifreeze) level came back very high. It turns out that my patient tried to commit suicide by drinking antifreeze, and she had dangerously high acid levels as a result. I, therefore, came back into the hospital from home to put in a special tube so she can get emergency dialysis. She did well after that and was discharged to an inpatient psychiatry facility.

I frequently share this story to highlight my ICU Rule #6: “Your Ego Can Be Dangerous.”

We can never let our ego get in the way of patient care. We need to always keep a sense of humility when dealing with the patients for whom we care. In this case, the Poison Control trainee was absolutely right. My patient did not have sepsis, but indeed had ethylene glycol (antifreeze) toxicity. I was wrong, and he was right.

In other cases, the bedside nurse may make a suggestion that turns out to be right on; or, the medical student may do so. We cannot be full of our own self and ego to not take suggestions from everyone in the care team. Different clinicians bring different perspectives, and as leaders, we need to welcome those perspectives.

We are all on the same team with the same objective: to help heal our patients. If we ignore salient facts or suggestions because a nurse or tech or student or therapist suggested it, we are liable to place the patient in great danger. We have to resist this with every fiber of our being.

I shudder to think about what could have happened if I ignored that little voice inside me which said, “Dumb resident can’t tell me what to do!” and NOT ordered the antifreeze level. I shudder to think about what could have happened if I continued to feed my ego in this case. It is a lesson I have never forgotten, and I pray that I never, ever forget it in the future.

Along the same vein, I can’t tell you how many times I have said, “Call a Code!!!” while working in the ICU. When I say that, it means that a “CODE BLUE” needs to be called overhead in the hospital. When this is called, as many people who can respond come to where I am with my patient. It is a call for help.

Now, I have been practicing in the ICU for more than 16 years. I have been blessed with a lot of clinical experience. I am confident in the clinical abilities with which I have been blessed. But that does not mean that I am “too cool” to call for help, which is my ICU Rule #7: You Are Never “Too Cool” To Ask For Help.

Sometimes, I will call for help before even trying. For example, if I see that a patient needs to be placed on a ventilator and they have a challenging airway, I will call my Anesthesia colleagues from the very beginning. Yes, I have placed hundreds and hundreds of breathing tubes in the throats of patient. That doesn’t mean that I am the world expert at it. I want what’s best for my patient, and if that means have an Anesthesiologist rather than me place the airway, then so be it.

Now, does my ego get bruised a bit if my colleague easily does what I couldn’t do? Maybe. But, who cares about my ego? We are dealing with life and death in the ICU, and I am not going to stick a patient’s vein or artery multiple times – for example – so I can save face. If that was my family member, I would want the same for them.

Our egos can be dangerous. We are never too cool to ask for help. Yes, we have the experience. Yes, we are confident we can do the job right. But asking for help is not a sign of failure. We are all one team, and we have the same goal: healing our patient. And if that requires asking for help, then that is what we should do.

The post ICU Rules #6 and #7: Your Ego Can Be Dangerous appeared first on Medika Life.

And this deadly disrespect isn’t confined to any one country. The World Health Organization has found it is a global problem where age is not revered but dismissed. Their 2021 report: calls out ageism for what it is: a socially-acceptable form of discrimination that impacts older people’s livelihoods, health, and even survival.

How long are we supposed to abide by these restrictions, a.k.a. biases, in medicine? The time has come to stop it and demand respect and appropriate care rather than resigning older patients to sit in a rocking chair and wait for the Grim Reaper to arrive to collect them.

I recall doing a Google search and seeing a reference to a 2013 statement by a country official who said the elderly should hurry up and die. I suppose that would solve what problem? What about the loss of experience and intellectual capacity, or was consumer product sales the only consideration? A shameful statement at best.

A 2020 report by the United National General Assembly noted that in their report, the independent experts stress(es) the lack of comprehensive and integrated international legal instrument for the promotion and protection of the rights and dignity of older persons has significant practical implications given that a) existing regulations do not cohere, let alone conceptualize regulatory principles to guide public action and the policies of government; b) general human rights standards do not consider the recognition of rights in favor of older persons; c) it is difficult to clarify the obligations of states with respect to older persons; d) procedures for monitoring human rights treaties generally ignore older persons; and e) current instruments do not make the issues of aging visible enough, which preclude the education of the population and with it, the effective integration of older persons.

If the world’s populations are not sufficiently educated regarding the rights and dignity of older persons, doesn’t it follow that it has worked its way into the practice of medicine? Undoubtedly, anyone older than 65 or 70 has faced that ignorance, bias, or whatever you want to call it when receiving medical care. It is not-so-hidden dismissive behavior.

Publications have indicated a disturbing occurrence related to elderly patients who leave hospitals sicker than when they were admitted. Research shows that about one-third of patients over 70 years old and more than half of patients over 85 leave the hospital more disabled than when they arrived.

One paper outlined reasons for improper or poor care of elderly patients (they failed to mention bias), which read: Poor management of the complex problems of the frail elderly can be summarized as follows:(1)inappropriate (2) incomplete medical diagnosis, (3) poor coordination of community support services, (4) overprescription of medications, and (5) underutilization of rehabilitation. The question of beliefs in medicine was addressed in another publication. Succinctly, it stated that positive beliefs=better outcomes.

I don’t care how many “training sessions” on experiencing the difficulties of the elderly are run in schools. Putting on padding, gloves, or special glasses is a momentary thing that doesn’t necessarily carry over to overt beliefs and behaviors with the elderly. It’s a lark for the attendees, not a change of view.

I’ve heard physicians remark how “old patients have a certain smell, don’t they?” Smell? Well, I suppose they can’t afford your cologne, after-shave, or taking their clothes weekly to the dry cleaners, doc.

A word to the elderly patients: Learn to dress for success, even if you can’t afford it and have to skimp on meals or medicine. Better-dressed patients are perceived as more worthy of care. Yes, I am being facetious, but it’s a fact.

I recall standing in a major New York City hospital hallway while a quite elderly man in a hospital gown was seated on a gurney waiting for a procedure. He was entirely alone in the room and without glasses.

A quite young staffer approached, pushed a clipboard and pen in his direction, and asked him to sign a release to participate in a research protocol. The man was confused and wanted to know what it was for, and the staffer, in a state of annoyance, told him he needed to sign it. Signing without knowing what he agreed to seems unethical to me. In “good patient” mode, the man signed on the dotted line, not knowing in what research he would participate.

The hospital, undoubtedly, makes a great deal of money and produces many professional papers, so getting subjects for clinical trials is of paramount importance. Forget about the patients; get them to sign.

Other older patients with Medicare coverage regularly are told, “Well, Medicare won’t cover this procedure, so if you want it, you’ll have to pay.” The “pay” part isn’t usually provided, and the patient must produce a credit card before leaving. Where’s the medical empathy about the issue? It’s missing.

Most of the time, the procedure might be “cosmetic,” like an ugly mole, an enormous cyst, or distressing marks. I suppose that means elderly patients shouldn’t care how they look and how it might affect both their self-respect and how they are treated? Thank you, Dr. Pimple Popper, but who pays your fees? Is it Medicare or Medicaid or the TV show’s producers?

We know that Medicare won’t pay for more than ONE hearing aid. How many people need only ONE hearing aid? Do they pay for more than ONE lens in eyeglasses?

Medicare is just as biased as those providing the services. And Medicare won’t pay for dental care, and we know that can play a role in various illnesses, including cardiac disorders. Are all the elderly on their own here, and should they let all their teeth fall out?

Are we reaching the point where the elderly patient in medical care no longer expects respect? Should they begin committing suicide, as has been reported happening in Japan during the lockdowns and loneliness of the pandemic?

The post Too Old to Live? The Scourge of Ageism in Medicine Cannot Be Denied appeared first on Medika Life.

Brad has served in leadership roles at EvergreenHealth, Cue Health and Shift Labs. His 20 years of experience as a doctor, ongoing work as an emergency physician and medical director of emergency preparedness, trauma and urgent care make him uniquely qualified to envision the quality of service for those seeking immediate care need.

Saving lives is a survival instinct for Brad. He earned a Bronze Star and Combat Medic Badge for his service in Iraq as a United States Army physician, and those experiences have enabled him to think about healing a fragmented system of care to make it far more responsive to patient needs.

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Gil Bashe: You and I both served in an army medical corps, you as a surgeon with the US Army, and I as a frontline paratrooper combat medic. We both had dramatic experiences in providing care. I went out with our soldiers to treat them where and when they were wounded. Fast forward, you served during the Iraqi War, when great technological advances in medical care were available. You saw that medical personnel were deployed piecemeal, and care was fragmented and provided by scrambling to get to patients. Tell us a little bit more about how those experiences framed your vision for patient care?

Brad Younggren: I completed my residency after September 11 (2001) and then joined the US military. Suddenly, I found myself transported to the middle of a major conflict as a squadron surgeon for a reconnaissance unit along the Syrian border.

When I arrived, the doctors and physician assistants were stationed in different places along the front. I couldn’t understand why. I thought: “We have helicopters, portable ultrasound machines, and video calling capabilities. Wouldn’t it be more strategic to position ourselves in Tal Afar, which would allow us to get to soldiers more quickly?”

Bashe: So, you saw the capability to use resources more effectively to treat patients faster to save lives. You recognized that you also had the technology to connect to the front-line instantly. What did that realization inspire you to do?

Younggren: When I saw critical time wasted and providers pushed to the point of injury, that launched this notion to use technology to save soldiers’ lives. When I returned stateside, I dived into technology visualization procurement for the Army. If we have devices that are durable enough for deployment that can extend our reach, we shouldn’t need to risk doctors’ lives by stationing them in Baghdad. Why not place them strategically in locations where they can sustain and save lives using technology at major medical centers such as Walter Reed Medical Center?

In 2010, I got out of the military and went to work for a company that developed the first Food and Drug Administration (FDA)-approved mobile-phone device. Now, we take for granted that a cell phone has better visualization than a hospital monitor. At that time, that wasn’t the case. That’s when I got my first taste of just how great an impact technological evolution could have on patient care.

Bashe: Can you expand on your decision to join 98point6? You saw the potential of technology to transform military medicine. Is the civilian world of urgent care very different? Why do you feel those in the healthcare profession must use technology to bring the primary care physician closer to the patient?

Younggren: As an emergency physician, I saw several failures within the healthcare system. During my time in the military, I saw how technology accelerated and could be leveraged to meet urgent medical needs. I recognized the need to build a technology platform that provides on-demand service at the point of care that also would reduce physician variability in practice.

Instead of repeatedly trying to get doctors to do something with an off-the-shelf digital plan, the only way you can impact change and care is to put technology tools and data directly into the hands of the doctor. Then they can make the best clinical decisions when they need to, in real-time.

Bashe: We both know how hard it is to change the healthcare system. You may need to push new ideas while old ones are still firmly in place. Tell us how the 98point6 platform is working to effect changes that will eventually transform the system?

Younggren: One of the primary reasons I came to 98point6 was to be the first point-of-care company in the room during every single patient visit. Almost all of our patient cases are handled via text (with support for photo/video as needed for diagnosis). We can capture all of the conversational information that occurs between doctor and patient, which informationally and procedurally, is incredibly powerful. If you want to understand how to impact the care delivery system, you need to fully understand the interaction: you need to be in those rooms.

Our Chief Product Officer Robbie Schwietzer helped build Amazon Prime. His acute understanding of consumer engagement played an integral role in the development of our platform. We are committed to providing a pleasurable experience that gets people the care they want and need.

That’s key to the transformation of care, and we have patients tell us all the time how easy-care is for them now. They’re on a bus or in a meeting when they’re engaging in care, and that’s the beauty of it. You don’t even need to be on video: you can access care from physicians in an incredibly convenient, nondisruptive way. And that’s going to change how consumers want to get care, and how they expect to access it.

Bashe: Most certainly, you are familiar with Dr. Eric Topol’s book “The Patient Will See You Now?” Is 98point6 the transformation from question mark to exclamation point to the polemic he raises?

Younggren: Yes, I’ve read the book and considering Eric’s view that the smartphone is the agent for transforming care, and digitally empowered patients can take charge of their health care, I hope that he would believe that we are the kind of “bottom-up” care that he envisioned.

Ultimately, we’re a technology-driven, care-delivery platform where every case is backed by a doctor. We’re leveraging our technology and physicians to deliver better patient outcomes because that’s truly where the magic happens.

Bashe: Tell me about the 98point6 physicians. Do they take on 98point6 work in addition to their private or group practices? Or are they dedicated to pioneering this sort of connective technology with patients?

Brad Younggren: It’s the latter. I spent a lot of time looking at the market and found that physicians are on the outside looking in. To build an AI platform where the AI is learning from the behavior of the physicians, and to deliver care in 51 jurisdictions on demand, we needed a cadre of dedicated, on-staff physicians.

With these goals in mind, we couldn’t rely on locum doctors, which most of our competitors do. We needed to train our doctors to properly use technology. Originally, we started with seven and now we’re up to approximately 50 full-time, board-certified physicians. We augment the full-time physician team with part-time, directly employed board-certified physicians who meet the same hiring bar and receive the same training.

Bashe: Going back for a minute to our shared past in military triage, how do you deal with the triage of specific health needs within the 98point6 system?

Younggren: We have a whole team that’s devoted to continuously improving virtualized or AI-based triage, and one of the angles we’re taking is how to triage based on acuity and immediacy of need, which is very similar to being an aide in an emergency department. We’ve already built AI-based tools to help identify suicidal patients and pull them up to the top, so you can locate the patients that need care most immediately. Even though we’re aiming to provide on-demand care for all patients, it still requires a bit of clinical triage.

We do employ some doctors part-time who can help fill in gaps as needed from a capacity perspective. Ultimately, we want all the doctors we employ to work for us forever, so any work we can do to make their lives better from the perspective of preventing burnout is really important to us. At the heart of it, we’re a physician-forward organization. We track their satisfaction scores and constantly ask what we can do to make their experiences better.

Bashe: Describe the relationship between the primary care provider and the patient from a technological standpoint. Do you feel that 98point6 has maintained a relationship there or is it more functional than anything?

Younggren: Our theory at the beginning was based on research in computer science that shows patients can develop relationships with technology. Because we’re on-demand, it’s basic to our system that patients develop a relationship with 98point6 versus our physicians — it’s simply unrealistic for each of our doctors to work 24–7. We constantly strive to provide a peerless experience for patients that builds a level of trust with the brand, regardless of the physician on duty.

Bashe: In this country, 90 million people are pre-diabetic, but only 1 in 4 know that are trending toward diabetes. If 98point6 has a relationship with the customer, and you see that they’re pre-diabetic, do you simply say your blood glucose is a little high, you should be more mindful? Or do you preemptively engage that patient/customer?

Younggren: At the most basic level, we’re focused on invoking the standard guidelines of preventative care. So, let’s say a patient is 45 years old with a family history of colon cancer. We can catch that and recommend a colonoscopy, especially if they’ve never had one. There’s still a lot more work to be done in making preventative care more effective, as well as care navigation, chronic disease, behavioral health and we’re constantly looking to improve these areas.

Bashe: How do you feel about empowering faster engagement and the use of artificial intelligence, or even a medical chatbot to do so?

Younggren: There are a lot of symptom-based chat boxes on the market, and this technology isn’t inherently connected to a doctor. Even if a chatbot supplies the top four diagnoses to a patient, when a physician comes into the picture, they still have to backtrack to understand what has happened in that technology experience to build trust, provide an accurate diagnosis, and determine the next steps. That takes additional time and effort, and patients feel that.

I believe you need physicians trained to use technology that is fundamentally connected to the practice of medicine. In that case, technology is extending the reach of a physician’s hands and it’s a pretty cool, proven approach.

Bashe: I noticed that you’ve been tapped by major corporations as their medical service partner of choice. What’s the driving force behind these partnerships?

Younggren: One of the great things about working with employers is that we make a real concerted effort to understand their challenges and the problems their employees face. For instance, when the pandemic hit, we had to figure out a way to support employers with COVID testing in several different contexts.

Large employers trust us to give them high-quality care, but it goes beyond that. We’re having meetings regularly to better understand what their pain points are and where we can use technology to make the greatest impact. Many times, patients don’t know the extent of their medical benefits, but we know exactly what their plans are, and can recommend other services they might need, whether it be substance abuse support or behavioral coaching, that they’re not even aware they can access.

That additional ability to increase the utilization of other services these employers are paying for is a win-win for employers and their employees, who can further improve their health and enhance their quality of life.

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As an experienced combat physician and trauma care specialist, Dr. Brad Younggren — applying technology to accelerate access to care — demonstrates the digital transformation occurring in the health ecosystem. He is centering medicine around the patient and selecting to reinvent care, not by planting technology into a system seeking to keep it away at arm’s length, but rather by inviting physicians who select to be on the frontlines of care to use innovation to improve people’s wellbeing.

The post People Needing Access to Care Shouldn’t Have to Do Battle to Get It appeared first on Medika Life.