The Doctor is not Enough

One of the most eye-opening parts of recovering from a workplace injury was realizing that the medical care I was receiving wasn’t enough. To be precise, I really didn’t understand what surgeons do and what role they would play in returning me to full function. My expectation was that my spine surgeon was going to shepherd me from seriously injured to fully recovered. Not only is that not what they do, it’s not what they are expected to do. I now understand the surgeon was responsible for the carpentry aspect of fixing my spine after my car accident, and that job was pretty much over when I was sewn up and discharged from the hospital. But wait a minute, you glued me back together, now how do I get better? The healing and recovery part is the gray area that patients know little to anything about - and the part they expect their medical team to help them with.

If I learned anything along the way of trying to optimize my recovery it was the doctor needed my help if I want a rapid and complete recovery. Writing about the patient experience in my book, The Optimized Patient, I was confronted with the uncomfortable truth that all I was going to get about my recovery was a one-page FAQ explaining if you have a fever, inflammation, vomiting or diarrhea, call the doctor’s office. If not, we appreciate your business, see you in six weeks. I knew something was wrong about that, but funny thing is, it wasn’t the patients I interviewed that confirmed to me that there was something really wrong with that. The surgeons I interviewed readily admitted, if not complained, that without a patient educated in the recovery process and engaged in their own recovery, the doctor just isn’t enough to help you fully regain your good health.

Brian Allen has pointed out for years how health care has been marketed in this country by saying, “Take this pill or have this procedure and your problems are solved and that mindset totally disengages patients from their own recovery.” Interviewing a doctor for a book on patient recovery is a very different experience than being a patient trying to understand a pre-op order in an exam room. Dr. Christopher Hills, an orthopedic surgeon in Jackson, Wyoming startled me with his concern about how difficult it is to optimize a patent for surgery or injury recovery. I am a novice in the workers’ compensation space, but I am pretty sure what Dr. Hills said may be fresh news to all of you. “You could have an absolute perfectly done surgery, textbook, everyone’s high-fiving at the end of the case, ‘Boy, that couldn’t have gone better.’ You could have an absolute surgical success and have an absolute clinical failure, and that could be for many reasons. Again, patient expectations. There’s a lot of psychosocial issues that come into this, a lot of factors that can give a clinical failure even though you had a surgical success.

Having to bring all those together and have them align is critical, and I think that’s something we didn’t pay close enough attention to in the past when it comes to spine surgery and such.” Dr. Branko Skovrlj is an orthopedic surgeon a world away in New Jersey. His view of the limits to what a surgeon can do for a patient echoed what Dr. Hills had to say. When I shared with him what I was hearing, Dr. Skovrlj said, “People want instantaneous results. They don’t want any involvement. So, just like you said, there’s no magic wand. We’re here to facilitate the healing. We’re here to put your body into a place where you can take over and heal it, but a lot of patients, they just want to come in and out, be fixed, and move on to doing what they were doing before, which leads to the problem of not taking care of themselves.” The patient education program that sprang out of my book is focused on the notion that the patient is the wildcard in the recovery process. Said from my patient perspective, I wanted to get better, I just did not know how. Yes, I had state of the art surgery and excellent physical therapy. But, I learned along the way that I also needed to have a positive mindset and to be committed to proper activity, healing rest and targeted nutrition. I learned that those “pillars of recovery” make it possible to get better faster and stay better longer.

Patient education is a missing piece to the recovery puzzle precisely because the doctor is not enough. Unfortunately, I learned all of this over the course of years struggling to successfully regain function. In the workers’ compensation process, that unnecessarily long timeframe can be very costly both in dollars and unnecessary human suffering. To provide the essential recovery guidance that is typically no part of the patient experience I reached out to doctors, renowned personal development coaches and optimized patients who shared their wisdom in a series of videos and audio book excerpts. A meal plan crafted for surgical prep and injury recovery is also part of the weekly patient education and engagement program. Equally important is letting the injured worker know on a weekly call from a Recovery Guide that their employer cares about returning them to good health as quickly as possible. It has been my experience with workers in our program that focused patient education is the missing link in improving injured worker outcomes.

Every doctor will tell you they are happy to see comprehensive patient education incorporated into the recovery process because, frankly, the doctor is just not enough. 

Harvey Warren has enjoyed many careers from screenwriter to film producer to financial services professional. As author of the Optimized Patient book and survivor of three spine surgeries, he writes about the problem that “patients want to get better, they just don't know how.” Optimized Outcome Solutions translates his book into a service providing real-time guidance on how to “get better faster and stay better longer.”

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