Keeping Up

The only way to stop it is to willingly not pay attention.

The problem is, readers of this magazine find it very difficult to do this – we are compelled to attend the webinar, follow that email, open these pages.

We are continual learners. That’s part of the definition of ‘Professionals’ assigned by Dr. Pankey and others. Constantly seeking new answers for clinical puzzles gives us confidence to welcome the next health seeker to our offices. We want to be able to look our patients in the eye and transmit this confidence to them – everyone who puts themselves in a health care professional’s hand wants to believe they are safe.

How do we know what we are learning is the ‘right thing?’ If you have a foolproof answer for that question, please, share it with the world. No one else has figured it out. What we believe to be true and worthy of using for our patients’ benefit must be filtered through prior learning, personal experiences, our values, and our commitment to ethical behavior, however those things are defined by each of us.

Puts a lot of responsibility on each of us, doesn’t it? Yet, we willingly embrace that ‘burden’ because we enjoy the rewards of well-served patients and the satisfaction of sorting out the riddles, piecing together the pictures, imagining the best outcome, and encouraging changes of behavior that produce the high perceived value sought by our patients.

Where does that start? How can we become confident we can be the change agent most likely to ach

One of the many helpful books Dan Heath has written is Upstream, The Quest to Solve Problems Before They Happen. By telling stories of success looking at what is happening not as a current event but as part of a line of events, Heath points out that we can often change expectations by catching problems far earlier than we have been taught to see them.

Medicine is a symptom-treatment system, despite decades of effort to promote prevention through diet, exercise, and mindfulness. Dentistry, with an emphasis on controlling triggers to inflammation and adding fluoride, has a long and proud history of preventive focus. But dentists still face high demand for restorative services – the equivalent of medicine’s prescription page. Both address downstream problems.

Back to continual learning. Exploring the root causes of the symptoms presented allows us to think upstream. Since most of our therapies do not cure, but manage, chronic disease, there may be a way for the patient to work themselves upstream, if given a vision of the benefit.

Imagine the next sleepy patient in your clinic. They need help now for their downstream problems. PAP or OAT gets their airway, and their ability to see other choices, open. If we stop at these management devices, we do not honor our learning. We don’t apply the best of what we can do. Let’s lead them upstream.

What have you learned lately about endotypes, precision medicine, more targeted and easier diagnostics? Is there a way for you to direct your sleepy patient to make changes in lifestyle, in breathing patterns, in structure and function of the airway? These are moving treatment upstream and away from symptom-focused advice.

Continually seeking new knowledge allows you to keep up. Being a great doctor requires you to bring your patients up with you.