Slow Medicine and the Efficiency of Inefficiency
By Dr. William Winn, pulmonologist and member of the education committee of Kaweah Delta Medical Center.
Most of us will sooner or later be sick enough to require urgent and acute hospitalization. When this happens, we will receive state of the art care in our acute-care hospitals. Once admitted, we will probably do much better with sudden life-threatening emergencies than was the case in the not too distant past. For now, we no longer succumb routinely to heart attacks, and emergency surgery is better and more life-saving than ever. But, we also live in a time when current health care practices limit the duration of our hospital stays to just what is absolutely necessary. We are discharged “quicker and sicker” with a lot of pills, medical supplies, and other needs still to be met. Often when we are discharged we are still too sick to go home, and must go to other places to complete our recoveries. There, the pace of our care is slower and the need for it is longer. One person out of every three may expect to spend time in these other places – where months and sometimes years will go by.
Doctor Victoria Sweet (physician and historian) has recently authored the prize winning book God’s Hotel; a Doctor, a Hospital, and a Pilgrimage to the Heart of Medicine. She has kindly accepted the invitation of the Medical Staff of the Kaweah Delta Medical Center to present this year’s Norman Sharrer Symposium at The Fox Theater in Visalia, on Thursday, October 16th at 6:00 PM. Admission is open to the public and is free. Her book has been inspirational to its readers. She tells us stories about patients that she cared for at the Laguna Honda Hospital in San Francisco over a span of 20 years. Their stories teach us much about Care and Healing in “the last almshouse in the United States”. Dr. Sweet is a keen observer of the political and economic forces that have changed Medicine so much in recent years; forces and trends which have turned the traditional idea and meaning of Medicine into something so entirely different that we now call it healthcare.
The political and economic complexity of this Healthcare is a real problem; the costs are high and the outcomes not always what we would wish. Dr. Sweet’s talk is titled Slow Medicine and the Efficiency of Inefficiency; she will explain why slower bedside care (which medical economists think of as inefficient) may actually be the opposite and improve clinical outcomes as well.
Dr. Sweet believes that the pendulum is beginning to swing back. Slow Medicine is being increasingly practiced in hospitals and homes whenever the medical and nursing needs become more basic. In these climates of healing, doctors once again find more time to visit with their patients, talk to them, think and plan better care; nurses once again are enabled to give less hurried and more thoughtful “tender loving care” to these same patients and their families.
Dr. Sweet is a powerful advocate for all of us potential Slow Medicine patients. She teaches that the essence of the Slow Medicine hospital is its hospitality. Ideally, the doctors, nurses, administrators and other caregivers are the hosts and the patients are the guests. Here there is plenty of time for healing and recovery with the help of rest and therapy in peaceful surroundings. The food is good. It is transparent to the patients and their families that everyone cares for them and not just about them. Dr. Sweet the historian reaches back over a thousand years to the middle-ages (and the time of the first hospitals) when she introduces us to three “physicians” whose names are Dr. Diet, Dr. Quiet, and Dr. Merryman. These three spirits were the best of care givers in their time, and may be returning to our bedsides today.