Monday, January 21, 2013

NOCH Joining Michigan Health Connect Leaves Something Out

I was interested to read that North Ottawa Community Hospital in Grand Haven has joined something called Michigan Health Connect. As an article in the Grand Haven Tribune explains, the idea is that medical records can be shared efficiently in an online hub among multiple medical professionals so patients do not have to keep providing information with each doctor's office. Also, results of tests and other procedures can be shared immediately with other care providers.

All of that sounds ok. My wife is fighting cancer, works with multiple doctors in different facilities and specialties, and complains about multiple appointments, getting doctors to talk to each other, and having to repeat information multiple times.

However, her biggest complaint--and that of many other patients we talk to--is the difficulty of getting copies or access to HER OWN RECORDS. Some doctors offices are great about providing a copy of a lab test, a report on a scan and other records. A medical social worker, my wife has long advocated to others to stay informed about your own case and be your own best advocate when making decisions about your own care.

But Michigan law requires in some cases that a third party process requests for your own information. You have to fill out a release of information form--yes, giving some bureaucrat permission to release your own personal medical information to your own self. This already makes no sense. But then, we got a bill from some company in Atlanta for copying and mailing us records we had requested from a hospital here in Michigan. One wonders how such a law got passed other than that some politicians wanted to create unnecessary medical records jobs for a favored constituent group.

The Michigan Health Connect web site has a link "for patients" but reviewing it shows that they see patients as a group that needs to be convinced that this technology is necessary and secure. There is an opt-out option. But no where is there an obvious way to request access to one's own patient records.

I remain unimpressed with this system until they see patients as the primary recipient of medical records. Right now, if you're a patient, there are a dozen medical and insurance professionals who can see your records before you can. They boast that the system is secure. Then they should give patients an access log-in to see their own records.

Until that happens, Michigan Health Connect is not a complete remedy.

Saturday, January 19, 2013

Spring Lake Schools "Re-imagining" Needs Better Process

I may or may not eventually be in favor of what a special committee "re-imagining" Spring Lake Schools proposes. But for now all I know is that I was shocked to read a headline in the Grand Haven Tribune top of page one a few days ago saying that "Spring Lake Could Close School."

The key word was "could." But it was not a sensational headline: a committee really is considering closing one of the elementary schools.

I was a little shocked that this is the first I heard of the committee considering this. Apparently, a newsletter went to parents, and some parents are on the committee. But the community at large found out about this in a front-page newspaper article.

Superintendent Dennis Furton did not want the newspaper to cover the committee meetings. I'm ok with that. Anyone who is part of a large organization knows that formative work is best done by smaller committees. It's just not practical to have huge groups meeting to discuss and plan.

However, process matters as much as policy. And in this regard, the schools made two mistakes.

1. All community members, not just parents of children currently students in the schools, need to be seen as stakeholders and not bystanders. Certainly, parents may be more affected by what if any changes to the schools are recommended. But those without children in the schools are taxpayers, and they pay no less in taxes for not sending students to the schools. We are often reminded that public education is a public good, and that all of us have something at stake in the success of public schools. Well then, all of us should be kept in the loop. A full 83% of my property taxes go to the schools for one reason or another. I am very interested to know if and why that amount will increase.

2. Even if the committee is meeting privately, people need to be informed more fully of what they are discussing and why. I did not see that in the paper. It may have been in the newsletter to parents. The superintendent indicated that people could contact a committee member to give input. But without being fully informed about the background reasons for forming the committee, what the options are, potential costs and benefits of the status quo or closing one school and expanding another, it is hard for people to give input in a meaningful way.

Once the committee announces a recommendation, it will be interested to see what public support it receives. People who may have endorsed a proposal may object not only on the merits of the final recommendation but because they felt the process was not transparent. Now that the paper has brought the story to everyone's attention, the schools have a chance to remedy this by having several public meetings to give this background. Then the committee can weigh community response as it continues to meet.

Pondering Pronto Pups Tradition

How long would you wait for a hot dog? My wife and I waited one hour and 10 minutes--70 minutes--for four hot dogs. That's 17.5 minutes per dog.

Actually, they were "pronto pups." Also known as corn dogs, or hot dogs on a stick dipped in batter and deep fried. Here in Grand Haven they are part of our community pride. And they are normally a summer thing. But every January the little hut on Harbor Drive opens for a three-day weekend and lines of my fellow locals line up in the cold for this little delicacy.

Some people were ordering just a couple to eat as they walked back to their cars to warm back up. Others were ordering dozens and walking away with boxes full of them. In the time we were there the line seemed to stay constant, with more folks coming behind us to fill in for those who walked away with pups in hand.

And I have to ask: why?

Well it could be just the tradition. What else is there to do in this beach town in mid-winter but stand in line in the cold with your neighbors for battered meat on a stick? It could be that it's a fundraiser, and people are willing to endure giving up some time and warm toes to help a cause. It could be just that people love pronto pups, and having a couple in January reminds them of summer.

Whatever the reason, we did it. The pups tasted good after the 70 minute wait. Now we only have to wait 5 months to have them again. At least then the wait will be shorter and the temps will be warmer.

Thursday, January 10, 2013

Considering the Stress in My Job Adds Stress

(From the January 10, 2013 issue of the Grand Haven Tribune)

Just before beginning the new semester this week I came across a “study” that lists the 10 most and least stressful jobs for 2013. University professor was atop the list of least stressful jobs. Of course, this has added considerable stress to my life.

I put “study” in quotes because I have issues with the method, conclusions and assertions in the report. You can read it for yourself here:

When I started teaching full time at the university level more than a decade ago, someone joked to me that being a professor meant I would be working 24/7: 24 hours a week, seven months a year.

That’s funny only because it perpetuates a stereotype held by the public that professors don’t do any real work. Apparently they think professors just show up when its time to teach, blather on for a bit, and then go do who knows what. Perhaps they make sure their elbow patches are secure and they have enough pipe tobacco.

The reality is far from the stereotype, as with any profession. I actually read a study once about stereotypes of various types of professions. It was done by a university professor, who may or may not have found the project stressful.

I’m not saying being a professor is as stressful as some of the jobs on the “most stressful” list: enlisted military personnel, military general, firefighter, and commercial airline pilot top that list. Those jobs all have lives at stake, and understandable stress. Although my brother-in-law is a commercial airline pilot and always seems enviably at ease when I see him.

Meanwhile, two of the other jobs that round out the 10 most stressful I have held before: public relations executive and newspaper reporter. I would agree that there is stress associated with those jobs, but being a university professor in my experience just adds different kinds of stress.

It’s also a little disconcerting to see the jobs that accompany university professor on the list of least stressful. Number two is seamstress. Since it’s after university professor on the list, it implies that a seamstress has more stress than me. Perhaps it’s from sewing elbow patches on the tweed jackets of all my carefree colleagues. The remainder on the list are medical records and lab technicians, jewelers, audiologists, dieticians, librarians and drill press operators.

Understanding how it makes sense to lump these disparate groups of professions together as lacking stress requires a look at the criteria. Apparently, the authors of the study considered 11 stress factors: travel, growth potential, deadlines, working in the public eye, competitiveness, physical demands, environmental conditions, hazards encountered, own life at risk, life of another at risk, and meeting the public.

Again, the life risk and work environment factors are clearly not an issue for a professor. But several of the others are a stress factor. There are numerous deadlines, from prepping for class, grading, completing numerous required administrative reports, committee work, and meeting deadlines to submit articles to journals and conferences. The latter is a very competitive enterprise, with most quality journals having an acceptance rate of less than 20% after articles are peer reviewed in a long and thorough process. And college professors are under stress to publish and present their work just to keep their jobs.

The study justified its ranking of college professors in part because college professors are "not evaluated by a standardized test. " But this begs the question, how are they evaluated? First, the minimum qualification for entry is a PhD. At almost every college professors are expected to excel in teaching, research or professional practice, and service to the campus and community. After every single class students evaluate profs, and these are pored over by review committees. A professor under review will also have their classes visited by colleagues who observe and write reports on their teaching.

For each review a professor submits a "review file" that is usually several three-ring binders with evidence of their work in the above categories. Not everyone gets tenure or promotion by merely showing up for a few years. I have watched painfully as several candidates in my academic unit did not get approved for tenure and had to seek work elsewhere. Even after tenure, the job is varied and demanding. Over the holidays I downloaded a time sheet app on my phone to get a better picture of where my time goes as I try to meet the multiple demands.

But, I’m not going to worry about some list on an obscure web site. I have enough to focus on with a new semester under way in a job that I mostly enjoy very much, in spite of the stress.

I wish everyone a 2013 with as little stress as possible, no matter what you do for a living.