My “Bella” is a long-haired, black-and-white “Tuxedo” rescue cat. Her veterinarian, Dr. Cathy Lund, opened an all-cat practice in 1998 in Providence, RI. As her website states, she thought being an all-cat vet was just “purr-fect for her”.
I work on the fringes of healthcare, now, usually in promotions or marketing for a particular advocacy initiative or to raise funds for the cause du jour. However, I spent over 25 years engrossed in healthcare – most of it in the marketing end of a large, national nonprofit. Some of it as a communications professional for a small local hospital in an urban setting.
I spend a great deal of observation time these days looking at healthcare and its changes, improvements, and fragmentation bringing those professional perspectives to bear. A year or so back I looked at these issues from the inside, when my daughter had a short and sudden illness. But, a few times a year I look at it from the perspective of a cat. A black and white perspective, you might say. And each time I wonder, what lessons can be learned from the world of vet care to the world of human health care about a more patient-centric system.
First, I imagine how her medical record “notes” section might read:
“Bella is now in her 13th year, and is relatively healthy, though has struggled with mild obesity for most of her life. Her weight-loss attempts appear to have been exacerbated by a psychological need to overeat, perhaps as a coping mechanism resulting from post traumatic stress disorder of unknown origin, occurring early in life. Genetic traits are unknown, as Bella was taken in as a homeless stray at a few months of age. Our family accepted Bella into a home that had experienced a recent loss of two adult cats to old age. Bella’s earliest days included gender confusion, as she was first thought to be male and referred to as Mason. She was also aware of early desires to take her to a shelter and adopt her out to another home. However, these additional early traumas soon resolved themselves, and Bella acclimated well into her forever family. “
Bella, which translates to “The Beautiful One,” aptly describes the prominent place she has taken in the family.
While Bella has not had any extraordinary illness, other than a mini-surgical procedure for a five-foot long piece of string down her esophagus and the extraction of several teeth, she is not an easy patient. Her unknown past, and suspicion of being feral, has meant a delicate handling. All eyes are on prevention. Preventive care has meant regular check-ups, shots, nail clipping, and blood work. It has also meant dealing with a progressively standoffish attitude, which has deepened with age into full-blown rage at invasive examinations and the sight of any other feline. Her “mental health problem” has exacerbated the provision of her medical care. Bella does not take well to invasive procedures, yet requires regular examinations of nails, teeth, and ears. Inoculations. Blood work. Cautionary procedures include full-length protective gloves for all medical staff. Mild sedation is recommended. Experimental prescription of valium proved to be ineffective and was halted.
Throughout her years of care, reminder postcards and e-mails are received when it’s time for a check-up. Appointments are made on the phone or by request over the website. You can even request an appointment on Facebook; there’s an app for that. Waiting time is less than a week [same day if there is a crisis, and phone calls returned within an hour, if needed]. Appointments are confirmed by e-mail, and again, a few days before the appointment, there will be another e-mail and a phone call, along with any special instructions, such as nothing to eat and drink after midnight. The day of the appointment there is no waiting, and because Bella is a mild-sedation patient, a first-in appointment is always available, so the distress of not eating or drinking since midnight is not too discomforting. When she is brought in, given her mild state of a building mental health crisis, she is talked to calmly and gently by staff. They pet her paw through the gate of her carrier and she is quickly taken in.
In an attempt to take care of her quickly, due to her sedation, one can only envision the Mario Andretti racing team pit crew being called to her tableside. They swoop down and, in quick order, in less than half an hour, the care is done. Using sedation on an older cat is a concern that grows with age, so the quicker, the better. Their specialists have come together, each taken his/her turn – nails, teeth, ears, shots, blood work, a little shaving here and there, and good to go. Recovery is almost immediate as the sedation wears off. With a groggy “hisssss”, we know all is well.
There are follow-up instructions and education at the front desk. A quick checkout and then the next appointment is set. There is the constant reassurance, explanations, and calm demeanor. There is even a pat on the back for me, when I’ve needed it. We are good to go. Within a few hours of being home, City Kitty will call to see how Bella is doing and if I, her caretaker, have any questions. They refer to her by name and speak in an unhurried manner. Later that afternoon I will get an email. It asks us to submit a review: how did we do, and are there any suggestions? A few days later, there is another call. How is Bella? We’re thinking of her. Here is the result of her tests. Guess what? She is at her ideal weight! May she live long and well, and just call us with anything.
I am often struck by the quality of the “kitty care” provided to Bella – and what we could learn from it that might be applied to “health care” provided to humans.
Slow down might be a start. Look the family and the patient in the eye. Call the patient by name. Speak as if you genuinely care, because I assume you do. Don’t be afraid to touch the patient, or put your arm around a family member or caretaker. Repeat instructions. Ask if there are questions. Ask again. Provide information. And, educate and follow up, in several ways, by e-mail and again on the phone. Have a website that has a picture of the patient and their information, too, so they can see their records.
Keep good records. Have a resource link that is tailored for different types of patients and conditions. Tell us about who works there – not just their medical credentials, but a little bit of the personal, too – and perhaps show us their photo. Include a way on your website, or by e-mail or on social media, for us to ask you to call us, or to make an appointment.
Bella’s birthday is in February. She will be 14. She will receive a birthday postcard from City Kitty – and an email greeting, too – just as she has every year.
As published in the June 8th issue of ConvergenceRI