We are living and working in a dynamic time for healthcare. New and exciting therapies are being developed and technology allows us to successfully, safely and effectively treat patients who previously would have died. However, we also face many challenges – such as a significant number of our patients who remain uninsured or underinsured.
And yet, there are a lot of things about the delivery of healthcare that separate it from being just a job, a source of income or a place to which to go every day. We assist, treat and care for patients and often times, become inspired by the people with whom we have regular contact. The sources of that inspiration are many and often include colleagues, ancillary staff and our patients.
The source of inspiration can be subtle and come unexpectedly. Such an instance happened to me just last week. I was asked to see a gentleman to evaluate an arteriovenous fistula (AV fistula) on his left arm which he uses four or five times a week for hemodialysis.
For those who don’t know, kidney failure is a very difficult problem to manage. When one gets to end stage kidney failure, dialysis treatment is necessary to stay alive.. One of the more common forms of access to the bloodstream for hemodialysis is to surgically connect a patient’s artery to a vein. This connection is usually done in the arm, and, when it functions properly, provides a high flow, superficial access site for fairly large needles which allow for blood to be taken out of the body and then, once cleansed, returned safely back into the body.
As I frequently try to do, I scanned the patient’s problem list in his electronic medical record so I would have at least some idea about his overall medical condition before the appointment. With a mental picture of a chronically ill and obese patient in mind, I entered the exam room to find a very fit looking gentleman waiting for me. I thought I had the wrong room...