Five Minutes to Fix Our Broken Healthcare System | Eva Lana Minkoff | TEDxSingSing

[Music]

so i went on this date with

a guy i met online good on paper

worst date ever

he shows up late barely says hello

hardly lets me talk before probing me

with a barrage of questions

and then he just walks out

and who gets left with the bill worst

date ever

undeterred i continue to online date

and i go out with this other guy also

good on paper

but this one led to a long-term

relationship

he shows up with a warm smile asked me

about something he found interesting on

my profile

and then we engage in meaningful

conversation about each other's

histories

the difference is clear one treated me

like

an objective the other treated me like

a person these are true stories about

experiences i've had

but i did lie about one little detail

these weren't dates with men they were

appointments with doctors

i spent 10 years doctor dating

searching for a diagnosis to make sense

of my mixed bag of chronic symptoms

it wasn't until this last doctor that

someone had intentionally asked me about

my life outside

of my standard medical history and

therefore was properly

able to diagnose me with fibromyalgia

so what's the message here that a good

on paper guy

can be misleading definitely true

but deeper than that whether

relationship is romantic

or clinical research shows that there

are

three essential qualities to every

successful relationship

respect communication

and trust this is true for couples

friends

partners parents and yes doctors too

unfortunately doctor-patient

relationships

aren't prioritized like our other

relationships

it's not the doctor's fault it's not the

patient's fault

it's the nature of our faulty health

care system

now it's not news that our healthcare

system is broken

and it is a multifaceted issue

but deeper than the obvious complexities

and disconnects

there is a crack in the foundation

that we often ignore a crack that can't

be patched up by

better technology more money a private

or a single-payer system

but it can be fixed by us

doctors are people patients are people

we

as people can take part in fixing our

broken health care system

because we make up that system

we don't need legislative change to have

better doctor-patient relationships

although many would argue that we need

more time

a doctor's appointment rarely is longer

than 15 minutes

so the question to fix our foundation of

healthcare

isn't only how do we build stronger

healthcare relationships

but also how do we do so quickly

and efficiently today i'm here to share

with you a tool

that takes only five minutes

my professional experience in healthcare

as a researcher and my personal

experience as a patient led me to create

a

tech company that uses compatibility

matching just like a dating site

to help people with chronic illnesses

find

their ideal doctor-patient relationships

in preparing for today

i asked our doctor and patient users

what their issues are with the

healthcare relationship as it is the

majority of our patients

agreed upon this sentiment

i feel like doctors don't care to

understand me

now i want you to imagine for a second

that we're talking about a marriage

or a life partnership if your partner

said to you

i feel like you don't care to understand

me wouldn't that be a

giant red flag that something's wrong of

course

but would we ever say that to our

doctors

so let's look at it from the doctor's

side what's their experience

well doctors have spent 10 plus years in

grueling training

in which they have had almost no money

time autonomy and then as they grow into

their professions they have to retain an

ever-growing encyclopedia of medical

knowledge they have to emotionally

engage and detach from dozens of people

each day

and at the same time keep in mind

financial legal and time constraints

they have dedicated their lives to

helping others

people don't become doctors to

self-serve they become doctors because

they have a passion

to help those in need

so our doctors what did they what were

their greatest complaints

their comments all boiled down to i feel

like patients don't understand

my limitations

they're in a tough place patients are in

a tough place

they don't understand me versus they

don't understand my limitations

both feel misunderstood and unheard

respect communication and trust are

absent

no relationship can thrive like that

so how do we close this gap in

understanding

when i was in college as a neuropsych

major my

family cardiologist let me set up a

study

summer study internship in hispaire

office

i was interested in studying the

definition of happiness

based on expectations so it went like

this

i'd go up to people in the waiting room

introduce myself

hey i'm eva dr smith's intern

would you be interested in joining me

for a few minutes to answer some

questions

they'd follow reluctantly and confused

clearly thinking why is this girl

bothering me

so i'd usher them in have them sit

across from me and then i'd have them

choose

a happy level face that best identifies

how they feel

the majority of the time

i'd then explain i'm going to have you

reflect on 10 different life

circumstances

please tell me if at this time your

expectations whether or not they have

been met

unmet or exceeded i'd ask them about

their

career their family life their health

and then i'd ask them to review each

again

and rate each in terms of importance

basically how much did

them how much do they matter to you in

the first place

and lastly i would ask if there are any

extenuating circumstances

extreme things going on in their lives

positive or negative

that would greatly influence how they

currently feel

things like divorce a promotion a baby

my study supported my hypothesis

one's level of happiness is defined by

their expectations

boom success

but the real success came from the

outcome

of conducting the study itself

in five minutes in a simple

questionnaire-based conversation

i had a 360 degree view

of each person's world way beyond their

health concerns

one woman even admitted to me now you

know me better than my best friend

is that all it takes five minutes

structured conversation active listening

what if our doctors knew us better than

our best friends

what if my doctor had would i have been

diagnosed sooner

there's one interview i'll never forget

this man joe a recent immigrant from

south africa

he was actually intrigued when i asked

him to participate in the study

but despite his cheery disposition

joe chose this face

so when it came time for the last part

of the study

extenuating circumstances i said to joe

you seem to be a relatively happy guy

joe your expectations have been met

or exceeded in almost every aspect of

your life

except family life which you've also

rated

of high importance if you don't mind me

asking

what is it about your family situation

that seems to have negatively impacted

your happiness so much

last year my family moved from the u.s

to south africa to protect

my daughter from the rising crime in our

country

shortly after we moved to the u.s my

daughter

was killed

yes i am a generally happy and positive

guy

but the pain of losing my daughter

inevitably impacts my happiness

so i try not to talk about it

joe came to see his doctor that day for

unexplained

chest pain tess weren't showing

any signs of physical issues so his

doctors had recommended that he take

aspirin in the meantime until they

figured out what was going on

joe hadn't told any of his doctors

about his daughter he didn't think it

was relevant

and doctors didn't know to ask he seemed

so

happy but in five minutes

joe trusted me an intern a stranger he

didn't know

because i had asked the right questions

to trigger a trusting relationship

which made him feel comfortable enough

to divulge helpful

context to his chest pain

relationships whether they're at home or

in the workplace or wherever

are the greatest contributors to our

happiness

if our happiness affects our health and

our relationships

affect our happiness how can we ignore

the necessity of relationships

in our health care the answer

is we can't

doctors patients all of us

are equally responsible for the

healthcare relationship

just like any relationship

knowing that how do we take action

at better addressing this responsibility

how do we bring

respect communication and trust back to

the healthcare relationship and how do

we do it

in five minutes

patience you can take action by first

recognizing that your life outside the

exam room matters

you don't have to tell your doctor your

whole life story but if it matters to

you

it's important even if it seems

medically irrelevant

advocate for yourself don't be

intimidated

that's just another person with a

stethoscope around their neck

a person who does care who does want to

help and understand

so do it together you're in a

partnership

and doctors you can take action by

using this tool a an in-person

brief but inclusive questionnaire method

it could save you countless hours

dollars and frustrations when you do

but you can adapt it to your own style

adapt it to your patients

for instance pediatricians you can ask

kids to give a

thumbs up or a thumbs down when asking

them about school

siblings bedtime ask more

listen more be curious

there's more to a person than what's on

their chart

and often they won't share with you

unless you ask

if joe had never exposed his

heartbreaking story

he would have been prescribed even more

unnecessary tests

and medications instead

he shared his emotional pain with his

doctor and found

the proper relief in therapy

when the qualities of a successful

relationship respect communication and

trust

are present between a doctor and a

patient

the impact is astounding

quality of life improvements better

treatment outcomes

fewer readmissions more efficient time

appointments

when we get to the true problem faster

there's a financial benefit to the

individual

and the system and true understanding

may only take the time of a few curious

questions

yes we would all love more time with our

doctors with our patients

but regardless of when or if

that ever happens we can fix our broken

health care system

now by bringing human care

back to health care thank you

you