Why we can’t fix our healthcare system | Ayesha Khalid | TEDxBeaconStreet

Translator: Jim Taylor
Reviewer: Denise RQ A while back, I was driving
to work one day, and my son Adam asked me a question, “Mommy, what do you do for a living?
What’s your job? I quickly answered, “Adam, I’m
an ear, nose, and throat doctor. I operate near people’s brains.” I peeked into the rear-view mirror.
He looked confused. I quickly added, “I help patients
to get more healthy.” He broke out into a big smile. Later that day, I went to clinic,
I started seeing patients and I forgot about this conversation. At the end of a busy day,
when I was an hour behind, I looked at the clock, it was 4:30, and I waked in
with my last patient, Charlie. As soon as I walked in, I asked Charlie,
“Hi sir, how are you doing?” Charlie bristled. “Do not call me sir. You are the seventh doctor
that I’m seeing. I’ve had oodles of tests,
multiple blood work, nobody knows what’s wrong with me, and I tell you, there is
something that’s going on.” Puzzled, I examined Charlie I looked inside his sinuses, and I tried
to figure out what was happening But nothing! I couldn’t find anything. So, I did what all of us sinus surgeons do
when we don’t know the answer: I ordered a CAT scan. Then I looked at Charlie and said, “While I’m excited to figure out
this journey with you and figure out what’s happening, I have to go. I’ll call you tomorrow
with the results of this CAT scan.” And off I went, to the hospital to see patients
and then back to pick up Adam. When I got Adam, he asked,
“Did you help patients today?” I smiled and thought of Charlie. “Yes, I did.” So the next day I went to clinic,
and I immediately open Charlie’s CAT scan and try to look through the images
to find out what was wrong. Negative. Nothing on the results. Nothing on the sinus scan. Essentially, I was still curious.
Puzzled, I scrolled the images myself. I looked through the brain images
and the neck images. And suddenly, I noted with growing horror
that Charlie had a mass that was growing in his brain
and eroding through the bone. I called him in, and I let him
and his wife see the scan. His wife started slowly weeping.
But Charlie looked relieved. “Thank you, doc, for believing in me.” And long story short,
Charlie went on to get treatment and still is doing well today,
cherishing his beautiful family. But this is not a story about me
as a doctor or Charlie as a patient. This is a story about
the 1,000 Charlies in the world who are unable to get
a health care diagnosis. Why is that? Why is it that we have
so many talented physicians dedicated to helping patients who are unable to help
the Charlies of the world? We all have heard of medical errors. Ninety-eight thousands people per year
are dying from preventable errors. But let me ask you guys a question. How many of you
have gone in to see the doctor, and the doctor doesn’t know
what’s wrong with you? And how many of you have a family member who you know has felt scared
because they don’t know the answer? So I’m here to [tell] you today that we can’t solve the health care system because maybe we haven’t been asking
the right questions. Einstein once said,
“We can’t solve problems by using the same level of thinking
that created them.” I’m here to tell you today that we need to adopt
a systems thinking mindset in order to approach
our health care crisis. And in order to do that,
I pose three questions for you today. Systems thinking is not a new philosophy, it has reframed conversations
in several industries, but the reason it’s important is it helps us understand
how things are related – events, people, and places –
even if they don’t seem connected. What it also does
is it looks for leverage points, small actions that have really big impact. So I’m going to ask you three questions that I think will help us
to find some of that impact. The first is how do we talk
to our doctor as our friend. The second is why is it
that competition is so bad in health care? And the third is why do we fear failure
and what we can learn from it? So let’s go to the first question. In order to answer the first question,
I want you all to think about this number. As a patient, when you walk in
to see your doctor, there is a 15% chance that they’re either going to
miss your diagnosis or have the wrong diagnosis
by the end of the visit. That’s going to increase your chance
of getting sicker or dying twice as likely. So where do we go from here? I think the systems thinking asks us to structure the conversation
completely differently, to take a step back and really ask,
“Why is this happening?” Perhaps because when Charlie
went to the doctor, he stated his problem,
then he received some tests, got a medication that didn’t help him,
and was sent home. And the pattern repeated itself. We’re trying to engineer a relationship between the doctor and the patient that is efficient but not meaningful. Perhaps what we need to do is change
the nature of the conversation and ask physicians to [mean]
that you are able to have the time to step back and listen
to Charlie’s story. In order to do that, we have to ask ourselves
the following question: shouldn’t seeing your doctor
not be something that’s rushed? In fact, I believe that seeing your doctor should be like getting together
with a friend for a cup of coffee. But I know some of you
are still thinking about this 15%. What if we don’t know
the answer as the doctor? What if we can’t find out
what’s wrong with you? Where do we go from here? This is where the health care system
and its competitive nature does not help us. So from the moment
we get into medical school, it’s a deep culture of competition. We have to get the best grades
to get into the specialties we want, be the best surgeon
with the fewer complications, and work in the best hospitals. And I found that despite my training
as a surgeon, despite doing research, despite teaching
at Harvard Medical School, all these enabled me to do is to continue to focus
on the body parts that I operated on and not really have a holistic view. The bigger problem with that was that I was so focused
on proving individual performance – for which we as doctors
are measured, rewarded, and now publicly displayed – that I didn’t have the time
to really collaborate with other doctors when patients were trying
to get a diagnosis. So this brings us to the third question: what if we don’t know the answer? What can we learn from failure? I have to be able to, as a doctor,
get permission from you, the patient to be able to look you in the eyes and tell Charlie, “I don’t know
what’s wrong with you. But I’m going to help you
get that answer.” We as a doctors have a lot of anxiety
when you come to see us. When we don’t know what’s wrong
with you, the stakes are high; maybe life and death. In that way, when patients come in and expect that we are able
to tell you what’s wrong, it really stresses us out
to not be able to do that. And so we reach, we reach for more tests in order to quickly
come up with a diagnosis. But what we really need to be able to do is go on this journey together,
to partner with out patients in our quest. Because for Charlie,
a systems thinking approach says that if he and I accept
that there is a possibility of failure, that I wasn’t able to see
this incidental finding on the scan, and that all of the doctors
that were looking for answers in him were very good doctors, but we were asking them specific questions
about a specific body part. What Charlie really needs is a better patient experience
through this journey. And in order to do that, he needs
to give me permission as a doctor to say, “I don’t know
what’s wrong with you, But we can get there together.” So that brings us
to the systems thinking approach which is downright confusing
when you look at it. But if you think about it, what we talked about here today
is reframing the conversation, making the doctor our friend, thinking about failure
and what we can learn from it, and perhaps changing the paradigm so that is OK with ourselves,
our colleagues, and our patients to not always know everything. Perhaps Charlie’s manifesto
or call to action today is really for you as patients
to be able to demand to tell your story, and for us as physicians to be able to
go on this diagnostic journey with you, and more importantly, to be able to look you in the eye
and tell you when we don’t know. Are we ready to accept this? My journey to systems thinking started
with Adam’s innocent question. But that very same day, I met Charlie,
and my journey continued. Getting to a diagnosis is not
the 100-meter sprint that we’ve created. It should be a relay race like a well-orchestrated race
with several runners in order for us to win. And more importantly, I didn’t come here today to tell you
how to fix the health care system. I’m simply here to ask you if you even think
that we are asking the right questions. Thank you. (Applause)

54 Replies to “Why we can’t fix our healthcare system | Ayesha Khalid | TEDxBeaconStreet”

  1. http://www.nps.edu/Academics/Institutes/Meyer/docs/A_Systems_Engineering_Approach_to_Developing_Business_Models.pdf

    Medical educators are not convergence thinking nor do they think in terms of systems engineers. That would be a good start.

  2. Ayesha, I enjoyed your presentation, and I appreciate your three points from a systems thinking perspective, especially the third point. However, I don't see ST (and your three points) as the most relevant aspect of diagnosis.  What stood out for me was when you said, "I was curious." Don't sincere curiosity about a patient's health encourage those three points (and others)? 

    It seems to me that physicians prescribe drugs too quickly. Perhaps they should be more curious like you.

  3. Great points, Ayesha! The biggest take away for me is remembering to slow down, ask questions, and look outside of the immediate problem area.

  4. "Asking if we are asking the right questions is so true." I see so many times from the entrepreneurial perspective that people just dive right in on specific solutions with no regard to the bigger questions of "why"?

  5. Excellent thoughts.  Very true that physicians feel strong time pressures in dealing with patients.  i also recall our conversation about how patients need to self-advocate and not assume that the doctor's initiatives in solving medical problems are correct.  We talked about the many options that cancer patients are presented and how difficult it is to navigate these options without good guidance.

  6. Excellent points. It reminded me about the manager's mantra "Don't come to me with a problem if you don't have a solution". A big mistake in my opinion, which threatens effective communication and limits problem solving in both organizations and in the physician-patient relationship. 

  7. I wish there was a bit more direction in this video than "lets re-think our approach" etc.
    Something like real life examples of where a different approach was taken successfully would have been good.
    Also competition in itself is definitely NOT the problem
    If the AMA & universities keeps restricting training quotas for Doctors – obviously the shortage will continue and the pressure to get patients in & out will too.
    More Doctors need to be trained, and more should be encouraged to become specialists
    Nurse practitioners should be allowed to administer routine checkups & procedures to free up the system
    A more cash based system where the PATIENT in charge is needed to encourage personal accountability and less waste

  8. Nice point to focus us.  Lot of problem and disease occur in our absence.  And also our health care problem. Specially Doctor's ignorance. For example  Doctor 's are so busy them self and also with money they forget their moral and profession.  

  9. This talk was quite interesting and did make some really good points, but I admit, I didn't think it would discuss this. I opened this video thinking that what needs fixing is how in the US healthcare system money comes before patients' health, and good treatment is a luxury rather than a inalienable human right. 
    Doctor's errors are indeed something that needs to be faced, but I really wouldn't think this was the #1 problem in the US healthcare system. Coming from Europe, it didn't even cross my mind that this would be the main issued discussed in a US-based talk!

  10. Ayesha Khalid's first question, to me is the most important aspect of health care. The patient-physician relationship is the first thing that should be analyzed, and I feel should be focused on more. Doctors don't take the time to build a relationship and really understand why the patient is there. Yes there are plenty times when people get checked out and its not severe. But as a doctor, you're obligated to treat every visit separately and form conclusions from hard evidence. Hard evidence is of course what shows from the tests, but also the patient's story. If this first step was taken more seriously, I really feel like our healthcare systems will be more efficient.

  11. Dr. Khalid,, A wonderful presentation with many answers to our HC problem, indeed. I like your idea of Einstein reference and partnering with our patients. I agree that we as physicians cannot be as effective as we can in partnering with the patients we are trying to help. I often tell my pregnant patient, that I can do only so much by seeing her so often but she is in charge 24 hours a day and if properly instructed and inspired to partner we can go much further on our journey to reach the goal of normal and healthy baby. You are also correct that small thing if done together much like tiny rivets on the huge airplane will enable its wings to carry a huge load.

  12. I believe it's not just a problem with the health care system but with the patients as well. Patients expect that the doctor will know exactly what's wrong in a matter of seconds which puts a lot of pressure on them. To be as effective as possible patients and physicians need to have a mutual understanding of the situation. In order for the patient to get the best care, the doctor needs to take the time to listen to the problem and carefully go over the tests so they can reach the correct diagnosis. Being in a pressured situation and jumping to conclusions right away can prove to be incorrect and possibly even cost someone their life. In today's world it will be very difficult to fix this problem because everything is based on deadlines. Your appointment time is only so many minutes long so the doctor has only that long to try and figure out the issue. Yes you could have longer appointment times, but that will only cause other issues because there's many patients to see and only so many minutes in a day.

  13. The most important part of this speech is when she covered the patient-physician relationship. I can say from experience that doctors don't take the time to build a relationship and really understand why the patient is there. As a doctor in the healthcare system, you're obligated to treat every visit separately and form conclusions from hard evidence. Hard evidence is of course what shows from the tests, but also the patient's story. If this first step was taken more seriously, I really feel like our healthcare systems will be more efficient. This might seem like a small “issue” but in reality it can make or break the healthcare system’s reputation. I’ve been to some doctors before where they assess me and get me out of there as fast as possible. That forms a void in our relationship, and made me not go back to that doctor again.

  14. I
    was extremely intrigued by Doctor Khalid’s approach to better the modern day
    health system. She went in depth of a personal story of an interaction with a
    patient that was having trouble getting his symptoms diagnosed. This patient
    has gone to multiple previous doctors in hopes of figuring the problem out to
    no avail. When this patient went to Doctor Khalid the process seemed to be
    going down the same road, but Doctor Khalid ordered a CAT scan even though her
    medical knowledge of the situation in the current frame of mind told her that
    this was a wild goose chase. At first Doctor Khalid didn’t see what she was
    looking for in the imaging, but due to her determination to find what his
    discomfort was, disregarding the tendency to stop searching, Doctor Khalid
    arrived at the problem. When Doctor Khalid told him what was wrong the man didn’t
    look sad (as what you would expect). He was happy, and the man thanked the
    doctor for believing what he was saying. Now this story she goes on to say that
    the competitive nature of the current healthcare system is a huge factor in
    misdiagnosing patients. The road an individual has to go down to become a
    doctor is extremely competitive and creates a tendency to only focus on a very
    specific area of study. It essentially puts blinders on the doctor, and this
    she believes is the reason for the fifteen percent misdiagnosis that makes the
    chances of illness and death twice as likely. Continuing this frame of thinking
    will not fix the problem. Einstein has an enlightening quote used by Doctor
    Khalid saying, “We cannot solve the problems by using the same kind of thinking
    used when we created them.” So how does she change the frame of mind to solve
    this problem? The questions she believes must be asked to solve this problem
    are; how can we get doctors and patients to talk as friends, why is it that
    competition is so bad for healthcare, and why do we fear failure? Let’s take
    the first one for instance, and get the patient to talk to the doctor as a
    friend. What can be the perceived result of this action? I believe this action
    will result in a better relationship between the doctor and the patient. Which in
    turn will make the patient more open and share very specific details that would
    not be shared otherwise. Therefore giving a wide spectrum of information the
    doctor can better make a decision in the diagnosis due to taking Einstein’s
    suggestion and tackling the problem from all angles by combating systematic
    thinking that has led to misdiagnosis, wrongful prescriptions, and not fixing
    the problem. The next question brings to the forefront the negative effects of
    competition in healthcare. As discussed before the current competitive system
    causes the doctors to approach and fix the problem solely by focusing on their
    specialty, not the problem itself. The doctors tendency when troubled on a
    problem is to go deeper and deeper into their own specific practice, and if no
    answers pop out they will dismiss the patient due to systemic thinking in a
    practice if the symptoms don’t match the criteria there is no problem (or a
    problem that doesn’t need medical attention). I would also like to bring the
    positives of competition in the state of fairness to give us a prospective on
    the truth. Competition in healthcare will bring out the most talented
    individuals, and weed out those that could prove incompetent in that field. This
    reason alone probably has saved so many lives that would have been lost otherwise.
    Next competition in the health field will keep a monopoly at bay and therefore
    makes healthcare more affordable. The last positive thing on competition in the
    healthcare is the drive for the doctor to be better than the surrounding
    doctors to gain more patients, indirectly giving the patient better care than
    if there was no competition. I believe the problem presented by Doctor Khalid
    is important and healthcare should always strive for perfection and the answer
    is not to take away competition, but instead create greater relations between
    practices as well as patients. This way you can take Doctor Khalid’s advice
    while still preserving the positive aspects of competition. This system will
    allow; the patients to speak more freely to the doctor, the doctor to get a
    prospect view of the patient’s situation, and allow the doctor to get a wide
    range of specialties by discussing with other doctors (but specific identities
    should still be preserved by HIPPA). The perceived result would take the pressure
    off the original doctor, and discourage rash inaccurate diagnosis. Now the last
    question Doctor Khalid brings to our attention is why do we fear failure? Now she
    doesn’t go in depth with this question but I believe it is more of bringing
    awareness to the fact that we can’t stand taking defeat. This can be dangerous
    in the health field if this fear of failure is to come up with a diagnosis. I
    believe the previous suggested plan would decrease the fear of failure’s
    negative effects on doctors by allowing them to admit “I don’t know” to their
    colleagues as well as allowing the patients to give a thorough description of
    the problem.

  15. I agree very much with Dr. Ayesha Khalid in her stances on the modern day health care system. Her approach to better the health care system could really make a difference in how doctors treat and assess their patients today, and could also really help with failures in the system. In the video, Dr. Khalid talks about a personal story with a patient named Charlie. Charlie went to her office seeking help that he has not received from many other doctors. He then explains to Dr. Khalid how frustrated he is with the healthcare system because he has been to so many doctors and specialists and not one has been able to tell him what is wrong or diagnose him with anything, and he knew something was wrong. Dr. Khalid was very bothered by his frustration and reassured Charlie that she will end his streak of being let down by other doctors. She tested him for everything she could think of with his symptoms and every test was coming back normal or negative, so she then ordered a CAT scan. The CAT scan did not seem to be necessary with all the work she had done prior to, but she was not letting Charlie leave without answers. When the results came in from the CAT scan, everything seemed fine, but that was not good enough for Dr. Khalid. She went through the images herself and ended up finding a mass on Charlie's brain. As she told the news to Charlie and his wife, Charlie felt a sense of relief and thanked the doctor. Charlie's reaction speaks volumes. He was RELIEVED to find out he had a mass on his brain only because he finally got his answer. This addresses the problem that Dr. Khalid is attempting to fix in the healthcare system. Doctors not taking the extra step in finding a diagnostic for a patient mainly due to the fear of failure. With this problem in mind, Dr. Khalid proposes three questions; How can we get doctors and patients to talk as friends, why is it that competition is so bad for health care, and why does the medical field fear failure? An answer brought up that addresses all three questions is that we need to make doctors more focused on bettering the patient and not themselves. Directed at the first question (getting doctors and patients to talk as friends), doctors need to be willing to take the extra step in getting personal with their patients so they are comfortable to tell them that they might be unsure of the answers for them at the time, but will do everything they can to get them their answers to solve the problem. In turn, the patient needs to be willing to accept the doctor's answers and understand that they will do anything possible to help. To address the second question (competition in healthcare), doctors today are more worried about getting higher up in their practice and making the most money than connecting the right way with their patients. This is not to say that all competition is bad, some competition can be positive as well as some can be negative. Some positive aspects of competition is that it weeds out the weaker party trying to be doctors in which is a big part on what is saving patients lives to this day. Another is that it makes doctors strive to be the best at what they do, meaning they will gain more patients and in turn gain more experience to help further them in their career. The problem is, is that there are overpowering negative factors to competition and that the negative factors tend to be more commonly noticed than the positive. One negative part of competition is that it turns doctors and other medical professionals against one another, which denies them the opportunity to gain knowledge from fellow superior or non-superior colleagues. Another negative aspect of competition in healthcare is it brings more of a focus on social gain such as status, ranking, or money earned. As said in the video, doctors need to focus on gaining better relations with patients and fellow medical professionals to help them have a better chance of succeeding in their career. By doing this, it will not get rid of competition as a whole. It allows you to take Dr. Khalid's advice while still preserving the most important positive aspects of competition while also allowing us to remove the negative aspects. To address the final question (medical field fearing failure), this connects all the points Dr. Khalid made together. Doctors in today's world are so afraid of failure, they settle. They settle for the easiest route, whether that be diagnosing too quick, or not giving any answers. There is currently a 15% chance of diagnostic error on a patient's first visit with a physician, as said by Dr. Khalid. By implanting these questions in the healthcare field, that rate could drop tremendously. I strongly support Dr. Khalid with all of the points and solutions she addressed in the video. She allows her audience to see all different angles and perspectives of the topics she discusses which gives a fair opportunity to decide your stance on the topic.

  16. Reading the title of this video, I thought that this lecture would consist of insults and negative details about how the lecturer thinks the system is failing. Reluctantly, I was pleased to find that Dr. Khalid's presentation was actually about the ways communication can solve seemingly simple problems. Her statement about how the way health professionals should treat to reaching the final diagnosis should be like a pass the baton kind of transaction, is a very interesting proposal. It does, however, prove to be true when I think about the way my information travels through the healthcare system; myself, to the doctor or physician, to the hospital, to pharmacist, and then to the healthcare provider. It is a very race-like transaction, and that is where Dr. Khalid's
    idea of having a longer conversation with doctors shows beneficence. Just by her suggesting that sharing more information with a doctor could be rewarding, the benefits would come when I would get an appropriate diagnosis.

  17. I had this happen to me. Was the victim of an assault, guy broke my nose. first doc throwing meds at it, and then finally ordered a CT said nothing wrong, second doc looked at the CT saw that my airway was the with of a sowing needle, said go to see a plastic surgeon. Surgeon 3 hr north looked at CT and said she couldn't touch it identified that the septum was bent into an S shape, and was shoved to within 2mm of my brain. She refereed me to Georgetown Medical school, the head of Maxilla facial surgery, who was the only one qualified to repair the damage.

  18. I agree with Dr. Khalid that there is a lack of communication between patient and physician. Patients want answers, and physicians want to give them those answers. She made a good point when she said that the patient and physician need to partner together. Patients need to be more aware of their health, and the healthcare they're seeking, while physicians need to specialize patient care, and not generalize it. Patients need to allow medical professionals to work through their healthcare issues and understand it may not be a quick solution. The patient-physician relationship needs to grow stronger in order to "fix" our healthcare system, and patients should always feel open to question their doctor's treatment plan or diagnosis. You should always be your own patient advocate.

  19. hello I!m from the uk in this country we give our doctor as much information as we can so he/she can make a diagnosis and direct us to a solution and treatment without fear of the costs.however in your country maybe patients do not disclose for fear of high bills or affordadlity ostrich and sand .

  20. The best doctor I have seen ask me what I think is going on then examines me and gives me options in resolving my concerns.

  21. Prior to watching this video, with the title stating "Why we can't fix our healthcare system" I wasn't certain whether Dr. Khalid would be addressing many issues throughout the entire health system or a particular, more direct topic. I found the topic of doctors to have a better understanding of their patients and working with them for each diagnosis, to be very insightful and something that I can agree with that needs more focus. As Dr. Khalid referred to how there is many physicians that are unable to help the question mark cases, it was a good point that the patient and doctor need to work together. If the physician is only trying to find an answer because they feel pressured or for the sake of their job, rather than actually wanting to help the patient and find the answer for them, they are less likely to gain all information needed and work towards the final goal. I can also see as well though how the patients can be partially at fault if they're more angered as to that the doctor isn't fulfilling their position and unable to help them and expecting them to know instantly. By both the patient and physician having the same understanding and taking the time to ensure the correct diagnosis, there would be many less mystery cases.

  22. I do agree with Dr. Khalid when she says there is something they need to fix in healthcare. She understands how frustrating it may be to not know what is wrong with you and to not be able to figure out the problem. The patient and doctor both want answers and want to figure out the diagnosis. Also, the patients need to understand it will take doctors some time to figure out what is wrong with them. Sometimes it takes days or weeks but they need to be patient. Doctors also need to know they will fail but can learn from it. Doctors will not be able to satisfy every single patient that comes through the door. I believe Dr. Khalid is right when she says they need to change the nature of the conversation and ask physicians to make the time to step back and listen to the patients stories. Nothing should be rushed.

  23. One very important part discussed in this video is the patient-physician relationship. I know from personal experience that sometimes doctors really lack in the bed side manner part of training. My doctor back home is not very friendly and that makes going to the doctors even harder. She always has this tone in her voice they she doesn’t want to be there and it makes me feel bad sometimes like I am wasting her time and that’s not okay. Doctors are supposed to make you feel comfortable, like you can go to them with every and anything. She just seems like an all around grumpy person. I know personally I would feel much better as a patient if my doctor was cheery and happier.

  24. When looking at our healthcare system it is quite complex.  Because there is such a rigorous process in the healthcare system in things like diagnosing and actually finding problems with patients, there is always going to be that struggle in diagnosing patients.  I agree that we cant solve the healthcare system because we haven't been asking the right questions.  The three questions that Khalid introduces gives at least a push in the right direction to make an impact on healthcare.  Looking at the first question it is important that we know how to talk to our doctor and to receive the right diagnoses.  It is important to structure the conversation and to realizing why symptoms are happening.  Changing the nature of the conversation and coming up with key points and not rushing the situation.  Healthcare and its competitive nature make it almost impossible to change it.  Focusing on individual performance, doctors may not know what is wrong with a patient and should be able to say "Let me find out what is wrong." 

    There needs to be a partnership between the patient and the doctor to realize what is going on and to impact the healthcare system in a more positive way.  So, even though the title of this article says we can't fix the healthcare system, I believe through the connection with the doctor that Khalid brings up will put it in the right direction.  Maybe not fully fixing the system, I believe that asking the three questions is important in looking at how we can try to fix the healthcare system.

  25. I think that this video touches on a few good points about patient and
    healthcare provider interaction.  Today's society is all about results and turnover rate: the more people helped, the better.  This unfortunately leads to misdiagnosis and can lead to further illness or death.  Patients
    shouldn't feel rushed when going to the doctor and doctors shouldn’t
    rush to see patients.  Time needs to be taken on both sides to interact
    and listen with care.  Patients need to understand that the doctor might
    not always have an answer for what the patient is going through and the
    doctor needs to understand what the patient has been through.  When doctors don't know what the diagnosis is, it is important for them to tell the patient that they don't know but will do everything they can to figure it out.  Patients just want to understand what they're going through and to have a doctor guess rather than level with them and say they're not sure is a huge mistake.  I think that if healthcare providers take more time to really understand and relate to their patients they will end up providing the best care necessary even if they don't know all of the answers.

  26. Ayesha states that in order to approach the health care crisis you need to think outside of the box and figure out what is wrong with people. She gives the statistic that 11 people die per hour from a medical error. This is very interesting because a handful of the audience raised their hand when Ayesha asked “how many people have gone to the doctors and the doctor has told you they do not know what is wrong with you?” She then talks about her idea more in depth, sometimes the doctors are rushed to see so many patients that they miss something very important. This is where her statistic above comes into perspective, medical errors are acceptable because they do happen and that is acceptable. Although some errors are able to be prevented, they are likely to happen. She elaborates that errors are where competitiveness does not help the health care system. Rushing through patients is not helpful to any patients, rushing will sometimes cause errors. The point that she raised about competitiveness is very interesting because for most people, being competitive proves that the doctor is the best in their field and they are more likely to get their ideal job opportunity. But for others, competition is not ideal or important to them. Some doctors, like Ayesha, care about the patient’s experience too. The patient’s experience is important to many doctors but ideally, most doctors want to find the cause of the problem and move on to help the next patient. Some parts of this video are very relatable, but others are hard to grasp how it is holding our health care system back.

  27. I'm totally down on the chemical, bombarding with rays, and pill pushing system. I've had it! My Ins won't even cover a natural practioner. There are many natural cures available. Doctors have cured themselves and written books about it.

  28. I think the problem we have with our healthcare system is that we have a fee-for-service system an incentive for physicians to provide more treatment, more tests to charge people. So in a sense it's a sick care, not health care.

    I'm not sure if an improved physician-patient relationship is going to help. We have physician to patient ration way too low. And physicians have spent a lot of money and time to get to where they are, so their time worth a lot of money and they wouldn't want to simply get acquainted with all stranger patients. I think It would cost a lot more to the systems.

    Perhaps, if we can somehow make a robot doctor (AI around the corner, Alexa, Siri) that's ruled based, affordable and accessible to everyone just like a computer, that'd be a real disruptive innovation.

  29. Seeing my doctor is seldom like coffee with a friend. How about a guy who does at least 6 patients an hour, and charged me $285. When you work for $8 an hour, you make that in a good week. Spend it in 10 minutes and come back in two weeks, so you are spending half your income on 20 minutes a month and all the doctor does is look at your infected toe.

    This video had nothing to do with fixing the health care system.

  30. Had my Doc for many years now but sadly management keeps changing. Our appointment times keep getting shorter and basically everything is now on a fifteen minute schedule block to get in as many patients as possible. Doesn't matter how long you've been at the clinic or how far ahead you scheduled. Corporate greed is constricting so many GOOD Docs.

  31. CAN'T have it both ways. There is a reason for everything. 1) Can't sue the (poorly educated Hindu) Doctor for millions, then expect reasonable health care costs. These Drs have to carry VERY expensive insurance just to practice. This cost is passed on to the consumer. Therefore: American cities are filled with insurance companies who build 100 story buildings, then rent the extra space to lawyers. These lawyers look out of their windows and litigate the other insurance company lawyers, in the 100 story building down the street. During jury selection, they pack the jury with uneducated low class people, to insure victory! Many of these 'professionals' take half the awarded money. Always driving away in foreign luxury cars, to help the American worker. Great system we have developed.

  32. To answer your question: why aren't the Charlies of the world getting the necessary diagnoses? I offer this response which is based on both personal experience as a patient and a fellow healthcare professional. Apologies if the answer appears emotional but I am passionate about delivering care and it peeves me that professionals at times stumble at the most basic of principles: listening to the patient; I totally agree with you on that one. The first thing we are taught as nurses is the importance of communication, delivering information so the patient could understand it, benefit from the treatment and make an informed decision. the second part of communication is listening; not only hearing the words but attentively and seriously. My personal belief is that most doctors are problem solvers; as they listen to the patient, they are 'solving' the case study they are being presented with. The flaw here is that this is not holistic.

    I hold my hands up, as a student, I was given that exact feedback: "the patient could hardly breathe and you bombarded him with 20 questions!". My reply " I needed information so I could help him". So, although the intention is benevolent, the application was lacking and non-holistic. Another point, is that the patient is the one who knows exactly what they are feeling or experiencing even if they can not provide a self prognosis or name the cause of their current predicament. This is where the 'listening' part comes in. Listen to what the patient is saying and ask probing questions in order to hone down on the symptoms. Do the tests for pete's sake! Not just because you failed to determine what is going on but as a precautionary measure (forget cost!). If certain causes are ruled out early on, this would prevent diagnostic overshadowing or failure to diagnose and limit the number of people returning with more serious conditions.

    Apologies again for the emotional rant, but doctors have to stop believing they know better than the person who is going through the ailments (in certain cases), and hone their social and communication skills. I understand pressures and demands of the job could lead to some form of malignant alienation and a coldness on the doctors part but the patient remains a human being in need of help; and they are reaching out. Instead of the conversation flowing between adults, it becomes a parent-child interaction: 'take this because I say so, you don't need to know why'.

    Consider this event which happened to me the other day during a suicide prevention lecture: the lecturer made a statement that during the first two weeks of administering anti-depressants, the 'subject' may experience increasing suicidal thoughts and requested that doctors be mindful of this while informing patients as they prescribe the meds. The shocking response from a doctor present was: but research shows that 'prescribing someone a pill as effective as offering them talking therapy'!!! Shocking and mind blowing insight into how much faith doctors have in pills but not enough in human contact (and into how some doctors think). I hope more people stumble on your lecture and appreciate the importance of establishing a therapeutic relationship/partnership with the patient so instances of misdiagnosis would be a thing of the past. Thank you.

  33. Thank you for this thoughtful presentation. We need many more inspiring, engaging people like this fighting for better, more holistic health care, and for universal health coverage. Just imagine someone like her as surgeon general.

  34. There is a 100% chance that the doctor will have the wrong diagnosis, for doctors remain stuck in a Newtonian concept of matter, and a deterministic physics that is out of sync with reality. If the right diagnosis is made it is by accident, or by intuition not by expertise, moreover, if the right diagnosis is made the wrong therapies will be offered, because of the faulty premise of the medical model of human reality. Today, the first step to dealing with reality is lifestyle medicine (Whole Foods, Plant-Baed WFPB nutrition), which means the focus is now shifted to the causes of the disease, not the symptoms (effects), along with it we need to shift towards the concept of the quantum doctor (see Amit Goswami's book The Quantum Doctor), and reframe the whole healthcare model in that mode, which is to realize that at all times the mind of the patient that is the healer and whatever healing modality is chosen merely provides the added subject matter expertise for the effectiveness of the healing. It is therefore also of great importance that the patient have understanding of the methodologies used and a healthy belief and trust in them. Guiding the choice for the appropriate modality is therefore the first job of the lifestyle physician.

  35. Shouldn't all people start learning everything about medicine at age 5 that our education system now doesn't start teaching anyone until they're older (25-30) after they've decided to BE a doctor? All people should also start learning about science from age 5! Quite a few at age 3(savants). Nothing our current system teaches is helpful, at any point in Life. Computers can now educate every person without actual teachers and buildings. Every person should have a Universal Basic Income.

  36. health care delivery is a commercial action, which depersonalizes the transaction. difficult to change in a nation that is driven by money. what is clear, is that usa is dysfunctional in many ways that are the result of the founding fathers intention of protecting the opulent from the mob. dr khalid can talk as much as she likes, but nothing will come of it. madison put the nation out of reach of the people, lest they tax him and succeeding generations of plutocrats.

  37. Relax! – The ''Healthcare'' System can be Fixed Very Nicely Once And For All – By Radically Changing it (no Diseases, so no drugs, no doctors, no hospitals, etc. BS will be needed any more) – I got the Tool – In less than a month everybody will become Infinitely Healthy and by that – Immortal, for Infinite Health = Immortality (8,500 years guaranteed) – By doing just an exercise for a minute a day, that cures and prevents any Diseases, known on Earth, even Aging and Radiation Disease, for every cell of our bodies is then shielded 100% from any external/internal (genetic) detrimental impact (any Viruses and any other Pathogens are killed the moment they touch us) – In less than a month everybody will become Infinitely Healthy, Radiation-Proof (fit for deep space missions) and Immortal – Like the Gods who created us humans – I will describe my Discovery to everyone, who sends me an E-check for One Million US Dollars (money can be negotiated).

  38. We can't fix our healthcare system because every time we do, there is nothing but more government intervention. Until we let the free market do its work, this mess will continue.

  39. all aspects of health must be taken into account because health is not just the absence of the disease in the human body, we must go towards the promotion of health

  40. Still can’t believe that you lot in the US (as the most powerful nation on the planet.. $700 billion on military..) don’t have a government funded universal healthcare system .. like every other developed nation on this planet… it must surely say something mean about the US culture…?

  41. doctors are just as much a victim of the insane meat grinder as patients
    we need to undo the damage of the flexner report

  42. my doctors is full of locum so not a personal relationship at all, i have actually had 3 separate things brought to my attention bymy pharmacist (Susan), who knows me by name, daughters name, where i live etc

  43. Trust me competition is a GREAT thing in the health service, try living in the UK with the NHS it's AWFUL. They have no worry about doing a decent job, they put 25% of the budget away to cover their own incompetence. So why do they need to perform good? No one here cares about how good a doctor is, just that they're a doctor.

  44. We know the system is broken bc some doctors think they are G_d, and won't admit when they are wrong. I lived with an arrogant spouse who seemingly was nice to his patients and colleagues he wanted to impress. On a professional and personal note, I have been lucky to have had great primary care physicians. One of them gave my son a baby gift as an infant. This Internist went on to become the first female President of the AOA and Dean of a well-known medical school. Dr. Karen Nichols is admired by so many in the field of medicine. She is respected for the right reasons.🥇⚕️

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