A More Equitable Future: The Role of Caregivers in Healthcare Disparities

1 00:00:00,480 --> 00:00:02,404 Speaker 1: Welcome to the Healthy, Wealthy and Wise 2 00:00:02,524 --> 00:00:08,064 podcast with Dr William Chokta, MDJD. Our mission is to empower 3 00:00:08,125 --> 00:00:11,897 you with the knowledge and the tools you need to thrive in all 4 00:00:12,099 --> 00:00:16,184 aspects of your life. Join us now as we discuss everything 5 00:00:16,285 --> 00:00:19,823 from nutrition and exercise to money management and personal 6 00:00:19,862 --> 00:00:24,733 growth. Dr Chokta will provide insightful advice on how to 7 00:00:24,774 --> 00:00:28,064 improve your physical and financial health, as well as 8 00:00:28,103 --> 00:00:31,460 your emotional and mental well-being. Whether you're 9 00:00:31,481 --> 00:00:35,930 looking to boost your energy levels, unlock financial freedom 10 00:00:35,930 --> 00:00:40,207 or cultivate a more positive mindset, we've got you covered. 11 00:00:41,799 --> 00:00:45,901 Get ready to become the best version of yourself? So let's 12 00:00:45,941 --> 00:00:50,468 get started. Here's Dr William Chokta, MDJD. 13 00:00:51,289 --> 00:00:55,107 Speaker 2: Good morning, welcome to the Healthy, wealthy and 14 00:00:55,167 --> 00:00:58,886 Wise podcast. I'm Dr William Chokta and I will be your 15 00:00:58,945 --> 00:01:03,923 facilitator for this program. We're delighted to have you, and 16 00:01:03,923 --> 00:01:08,521 today we're going to talk about health care disparities and 17 00:01:08,600 --> 00:01:13,308 give you some ideas and some suggestions about how we can 18 00:01:13,909 --> 00:01:18,543 mitigate health care disparities and provide quality healthcare 19 00:01:18,603 --> 00:01:23,885 for patients that we deal with. As always, i like to start off 20 00:01:23,926 --> 00:01:27,359 with my beliefs. I believe that life is about being of service 21 00:01:27,501 --> 00:01:32,465 to others. I believe knowledge is power. I believe leaders can 22 00:01:32,504 --> 00:01:35,504 change the world. For our discussion, we're going to talk 23 00:01:35,543 --> 00:01:39,379 about the definition of healthcare disparities. We will 24 00:01:39,400 --> 00:01:44,109 talk about the definition of healthcare equity and we'll give 25 00:01:44,109 --> 00:01:49,941 you some specifics about how to merge the two. This is part of 26 00:01:50,022 --> 00:01:53,551 our masterclass series and, as part of the series, the three 27 00:01:53,631 --> 00:01:59,471 areas that we address are healthcare, some legal issues, 28 00:01:59,591 --> 00:02:03,641 potentially, and also some financial issues, potentially. 29 00:02:06,319 --> 00:02:09,310 Change is one of those things that will always be with us and, 30 00:02:09,310 --> 00:02:14,900 indeed, every day there will be some change in your life. I 31 00:02:14,960 --> 00:02:22,197 suggest that if you are having challenges with things that are 32 00:02:22,236 --> 00:02:27,599 going on, it has to do with your relationship with change. If 33 00:02:27,620 --> 00:02:31,449 you have a good relationship with change, then you are 34 00:02:31,468 --> 00:02:35,108 probably happy. If you don't have a good relationship with 35 00:02:35,149 --> 00:02:38,443 change, then you're probably dealing with more and more 36 00:02:38,502 --> 00:02:43,967 challenges. My point, very seriously, is to look at what 37 00:02:44,008 --> 00:02:48,121 your issues are and how you feel and to see what your 38 00:02:48,161 --> 00:02:54,406 relationship is with change. Let's focus in on our primary 39 00:02:54,485 --> 00:02:58,263 issue today healthcare disparities. Albert Einstein 40 00:02:58,383 --> 00:03:01,911 once said if I had 60 minutes to solve a problem, i would spend 41 00:03:01,971 --> 00:03:07,403 55 minutes defining the problem. Let's define what healthcare 42 00:03:07,443 --> 00:03:13,140 disparities is. What does it actually mean? Very simply, 43 00:03:13,983 --> 00:03:18,733 healthcare disparity means patients who are similar 44 00:03:18,853 --> 00:03:23,544 situated being treated differently. Let me say that 45 00:03:23,604 --> 00:03:29,855 again Patients who are similarly situated being treated 46 00:03:30,258 --> 00:03:34,588 differently. For example, two patients come into the emergency 47 00:03:34,588 --> 00:03:39,466 room. They're both 20 years of age, they've both been involved 48 00:03:39,506 --> 00:03:43,919 in automobile accidents, separate parts of the city, but 49 00:03:43,959 --> 00:03:47,300 they're brought to the same emergency room. Both are 50 00:03:48,022 --> 00:03:56,465 18-year-old men and have a fracture of the left femur, left 51 00:03:56,465 --> 00:04:03,391 leg. Patient A is the son of a member of the board of directors 52 00:04:03,391 --> 00:04:08,747 . Hospital has a policy that if any member of or family member 53 00:04:08,907 --> 00:04:13,700 of a board member comes into the hospital, they are to 54 00:04:13,760 --> 00:04:18,187 immediately notify the administrator on call and to 55 00:04:18,247 --> 00:04:23,254 make sure that the administrator gets involved with the care of 56 00:04:23,274 --> 00:04:28,165 that patient. Patient is placed in a private room and someone 57 00:04:28,206 --> 00:04:33,954 from administration will come down and welcome the patient and 58 00:04:33,954 --> 00:04:39,625 or their family member. Patient B 18 year old young man 59 00:04:40,545 --> 00:04:46,653 different accident but same problem fracture of the femur is 60 00:04:46,653 --> 00:04:51,783 brought into the same emergency room. He is the son of a single 61 00:04:51,783 --> 00:04:57,891 parent. His family, his mother, does not have insurance and he 62 00:04:59,932 --> 00:05:03,963 is basically healthy. Otherwise. He is placed in the emergency 63 00:05:04,024 --> 00:05:10,949 room and individuals interview him, x-rays are done and it's 64 00:05:11,009 --> 00:05:15,101 taken some time for them to get the doctor in to see him. There 65 00:05:15,141 --> 00:05:21,396 is a particular orthopedic surgeon on call and he's been 66 00:05:21,435 --> 00:05:24,062 called and they're trying to get in touch with him. What's my 67 00:05:24,122 --> 00:05:30,250 point? My point is two almost exact type of medical problems, 68 00:05:30,571 --> 00:05:33,482 but the treatment is different. So what we're going to do is 69 00:05:33,502 --> 00:05:37,387 we're going to explore why is it that some of the treatment is 70 00:05:37,466 --> 00:05:42,353 different in these situations and exactly what all that means. 71 00:05:42,353 --> 00:05:48,875 If we look very closely, situations like this happen in 72 00:05:48,915 --> 00:05:53,464 hospitals all over the country. The reality is that patients are 73 00:05:53,464 --> 00:05:59,533 not always treated exactly the same and there analyze the issue 74 00:05:59,533 --> 00:06:03,245 of health care disparity, and this is what we're going to look 75 00:06:03,245 --> 00:06:08,603 into today. There are a number of reasons for health care 76 00:06:08,642 --> 00:06:18,213 disparities. Certainly, it has to do with one's ability to pay. 77 00:06:18,213 --> 00:06:25,571 Sometimes It may have to do with one's ability to understand 78 00:06:25,571 --> 00:06:32,064 the environment, education, language All of these may. There 79 00:06:32,064 --> 00:06:36,293 will be limitations, or there certainly be influences about 80 00:06:36,353 --> 00:06:41,528 how quality care is rendered at a time. Whose responsibility is 81 00:06:41,588 --> 00:06:45,088 this? I'm going to argue that this is the responsibility of 82 00:06:45,108 --> 00:06:49,240 the caregiver either doctors, nurses and hospital employees, 83 00:06:49,661 --> 00:06:54,247 and my operational definition of caregiver is anyone who works 84 00:06:54,307 --> 00:06:59,877 in a hospital that has impact on a patient. Anyone who works in 85 00:06:59,937 --> 00:07:03,302 a hospital is a caregiver. Whether you're in food services, 86 00:07:03,302 --> 00:07:06,786 whether you're environmental services, whether you are 87 00:07:07,567 --> 00:07:12,754 provide my secretarial services or in surgery, or a nurse or a 88 00:07:12,793 --> 00:07:16,345 physician, it does not matter If you have impact on that 89 00:07:16,404 --> 00:07:21,422 patient's experience. You indeed are a caregiver And you're part 90 00:07:21,422 --> 00:07:25,288 of that team of individuals who are responsible for providing 91 00:07:25,329 --> 00:07:30,142 quality care for the patient. So one of the things that we've 92 00:07:30,223 --> 00:07:35,752 noticed is that, more recently, more and more patients are 93 00:07:35,793 --> 00:07:44,326 diverse, and one of the reasons for this is that in 2010, when 94 00:07:44,346 --> 00:07:48,011 the Affordable Care Act was passed, that increased the 95 00:07:48,091 --> 00:07:53,300 number of individuals who basically have health care. It 96 00:07:53,319 --> 00:07:57,526 expanded health care coverage, fortunately for large, for 97 00:07:57,567 --> 00:08:01,413 millions of individuals, of patients, so that they could be 98 00:08:01,473 --> 00:08:05,798 provided quality care and live long and thrive like all the 99 00:08:05,838 --> 00:08:11,336 rest of us. Along with that that has brought in more challenges 100 00:08:11,416 --> 00:08:15,764 in the health care area, and it is our responsibility as 101 00:08:15,805 --> 00:08:19,269 healthcare providers, like myself and others, to meet those 102 00:08:19,269 --> 00:08:22,053 challenges and provide the very highest quality of care 103 00:08:22,574 --> 00:08:27,059 possible. So there are a number of reasons for these disparities 104 00:08:27,059 --> 00:08:32,085 , and let's say, on the patient's part, age, genetic 105 00:08:32,306 --> 00:08:36,009 health behavior, chronic illnesses. There may be 106 00:08:36,049 --> 00:08:39,793 community factors such as education, health care access, 107 00:08:40,534 --> 00:08:44,863 community norms, neighborhoods. There may be system factors, 108 00:08:44,942 --> 00:08:49,967 such as local public health services, social services, 109 00:08:51,349 --> 00:08:57,596 social, economic and health systems. Never the least, it is 110 00:08:57,635 --> 00:09:01,740 the responsibility and my judge of caregivers those of us 111 00:09:01,821 --> 00:09:07,969 involved with the process of caring for others to make sure 112 00:09:08,548 --> 00:09:13,054 that we eliminate health care disparities as much as possible. 113 00:09:13,054 --> 00:09:17,105 So what are some of the solutions to health care 114 00:09:17,125 --> 00:09:20,958 disparities? First thing is that whenever there's a problem or 115 00:09:21,460 --> 00:09:25,767 circumstance that one is dealing with, it's important to, as 116 00:09:25,826 --> 00:09:30,499 some say, not to bore the ocean. I am sure you, like me, have 117 00:09:30,559 --> 00:09:32,884 been involved with many different meetings about many 118 00:09:32,923 --> 00:09:37,876 different issues involved in health care. But what happens, 119 00:09:37,937 --> 00:09:42,041 what tends to happen sometime, is that we try to solve all the 120 00:09:42,100 --> 00:09:47,527 problems all at once and to the extent that many times one feels 121 00:09:47,527 --> 00:09:51,610 overwhelmed and feel like that it's almost an impossible task. 122 00:09:52,576 --> 00:09:55,187 One of the things that I have learned in my 50 years of health 123 00:09:55,187 --> 00:09:59,480 care is to do the very opposite . It's to start small and then 124 00:09:59,539 --> 00:10:04,615 grow and do something larger, to start with the basics. So I 125 00:10:04,635 --> 00:10:10,638 would suggest number one let's not bore the ocean, let's not 126 00:10:11,840 --> 00:10:17,369 try to solve world peace or create world peace, etc. Etc. 127 00:10:18,054 --> 00:10:21,464 But let's do the things that we can do. Let's control the 128 00:10:21,524 --> 00:10:24,821 control of the boats, and indeed there are things that are under 129 00:10:24,821 --> 00:10:29,302 our control, and these are the things, in my judgment, that we 130 00:10:29,341 --> 00:10:34,903 should work very closely on. So let's simplify it. So how do we 131 00:10:34,942 --> 00:10:38,582 simplify it? First, let's start with the individuals involved. 132 00:10:39,054 --> 00:10:44,065 We have caregivers, like those of us who work in hospitals or 133 00:10:44,085 --> 00:10:48,100 provide health care services, and we have patients. We have 134 00:10:48,160 --> 00:10:53,403 two entities. Our goal is quality health care. Our goal is 135 00:10:53,403 --> 00:10:58,524 quality health care. So, in effect, the caregiver patient 136 00:10:59,187 --> 00:11:05,020 association is a relationship. It is a relationship, whether 137 00:11:05,081 --> 00:11:08,187 it's a doctor patient relationship, nurse patient 138 00:11:08,226 --> 00:11:11,350 relationship, caregiver patient relationship. It is a 139 00:11:11,410 --> 00:11:14,461 relationship. And we have some understandings about 140 00:11:14,522 --> 00:11:17,518 relationships, right. So we're going to apply those 141 00:11:17,577 --> 00:11:21,267 understandings to this very, very large and seemingly complex 142 00:11:21,267 --> 00:11:24,341 problem. So the first thing that we're going to start with 143 00:11:24,601 --> 00:11:30,225 is perception. Perception is reality. And let me be more 144 00:11:30,326 --> 00:11:38,144 specific. We know from our anatomy and our psychology and 145 00:11:38,224 --> 00:11:42,570 our psychiatry that what we believe affects how we think. 146 00:11:43,576 --> 00:11:48,985 What we think affects how we feel And how we feel affects how 147 00:11:48,985 --> 00:11:55,046 we think about that. What we believe affects how we think. 148 00:11:55,996 --> 00:12:01,327 What we think affects how we feel And how we feel affects how 149 00:12:01,327 --> 00:12:06,943 we act. If we have a belief system about a certain patient 150 00:12:07,004 --> 00:12:11,471 population, i guarantee you that's going to translate into 151 00:12:11,652 --> 00:12:17,143 our actions in dealing with that certain patient population, 152 00:12:17,783 --> 00:12:22,119 positively or negatively. So one of the things that we can 153 00:12:22,178 --> 00:12:27,335 control or have some control over is our belief system, and 154 00:12:27,375 --> 00:12:30,842 so I would suggest, to start with, if you're starting to have 155 00:12:30,842 --> 00:12:34,456 negative beliefs about a certain patient, you don't even 156 00:12:34,475 --> 00:12:38,004 know the patient, but you walk into the room and already you 157 00:12:38,044 --> 00:12:41,818 get an impression. And if that is, if that impression is 158 00:12:42,019 --> 00:12:46,667 negative, i suggest to you that you pause and take a step back 159 00:12:47,668 --> 00:12:51,340 and regroup, because already you're starting down a path 160 00:12:51,821 --> 00:12:55,246 that's probably not going to be beneficial to you and or the 161 00:12:55,287 --> 00:13:01,657 patient. So that's a very, very easy first step. Second thing is 162 00:13:01,657 --> 00:13:06,104 we're dealing with systems, hospitals of very, very large 163 00:13:06,144 --> 00:13:10,048 systems, offices, or significantly complicated 164 00:13:10,089 --> 00:13:14,059 systems, and what I have learned and what many of us have 165 00:13:14,100 --> 00:13:17,986 learned in quality management and quality improvement is that 166 00:13:18,147 --> 00:13:22,318 when problems develop or outcomes are not ideal or 167 00:13:22,440 --> 00:13:27,208 outcomes are not what we want them to be, nine times out of 168 00:13:27,288 --> 00:13:31,649 ten is the process, not the people. Let me say that again 169 00:13:32,495 --> 00:13:37,267 When problems develop, let's say in a hospital, mistakes occur. 170 00:13:37,654 --> 00:13:41,817 Well, things don't occur the way they're supposed to occur. Nine 171 00:13:41,817 --> 00:13:46,777 times out of 10 is the process, not the people. I remember at 172 00:13:46,797 --> 00:13:50,975 my hospital as Chief Transformation Officer, i used 173 00:13:50,995 --> 00:13:57,398 to say when in one of the regular C-suite meetings and the 174 00:13:57,398 --> 00:14:00,339 issue would come up where maybe a nurse has given the wrong 175 00:14:00,379 --> 00:14:05,442 medication to a patient, oftentimes the result would be 176 00:14:05,682 --> 00:14:10,784 folks would be fired. I would make the plea when people make 177 00:14:10,845 --> 00:14:14,940 mistakes, when caregivers make mistakes, do not fire them 178 00:14:15,581 --> 00:14:19,403 immediately. Send them down and have a conversation with them 179 00:14:19,865 --> 00:14:24,325 and say tell me what was going on on your ship when XYZ 180 00:14:24,424 --> 00:14:30,644 happened? Why? What's my point? Nobody comes in to work planning 181 00:14:30,644 --> 00:14:33,755 to make a mistake. As a matter of fact, that's an oxymoron. If 182 00:14:33,796 --> 00:14:37,802 you plan it, it's not a mistake. When a mistake occurs, it is 183 00:14:37,861 --> 00:14:43,705 not planned. What you will discover, as many have, is that 184 00:14:43,845 --> 00:14:48,020 you have a process that this nurse or doctor or healthcare 185 00:14:48,061 --> 00:14:54,903 giver is involved in. That creates an environment that 186 00:14:54,964 --> 00:15:00,524 causes them to make a mistake and not reach their 100 percent 187 00:15:00,585 --> 00:15:04,839 potential. What's my point? My point is look at the process, 188 00:15:05,341 --> 00:15:07,499 not the people. Now, certainly, you're going to look at the 189 00:15:07,539 --> 00:15:12,224 people to some extent and maybe one-tenth of one percent will be 190 00:15:12,224 --> 00:15:15,302 a people problem, but I guarantee you 99 percent of the 191 00:15:15,342 --> 00:15:19,941 time it's going to be a process problem. The one way you will 192 00:15:19,980 --> 00:15:23,538 know that is that you will have a problem. You'll have a big 193 00:15:23,599 --> 00:15:28,344 meeting and you'll do all sorts of brute-cost analyses on those 194 00:15:28,404 --> 00:15:31,582 problems and then you will come up with a solution for their 195 00:15:31,623 --> 00:15:35,019 problem. Six to eight months later, the same problem will 196 00:15:35,058 --> 00:15:39,943 occur again. After you have fired Nurse John or Nurse Mary. 197 00:15:40,385 --> 00:15:43,201 Somebody will say but I thought we solved that problem when we 198 00:15:43,261 --> 00:15:46,356 let so-and-so go. Well, you didn't solve the problem. Yeah, 199 00:15:46,397 --> 00:15:50,176 you did fire somebody, but the problem is in the process. It is 200 00:15:50,176 --> 00:15:54,523 not in the people. All you did was change and put somebody else 201 00:15:54,523 --> 00:15:58,982 into that same broken process. I would encourage you that if 202 00:15:59,003 --> 00:16:02,735 you were having challenges with quality, with your patients, to 203 00:16:02,794 --> 00:16:07,346 look at your processes more than you're looking at your people. 204 00:16:08,255 --> 00:16:13,543 That's more difficult, arguably, but it is most important to 205 00:16:13,602 --> 00:16:18,104 solve the problem. What is the solution to health care 206 00:16:18,124 --> 00:16:22,445 disparities? Well, the solution, obviously, is health equity, 207 00:16:23,076 --> 00:16:26,457 equality and treatment for patients, for all patients, 208 00:16:27,080 --> 00:16:30,779 irrespective of their status in life, irrespective of what 209 00:16:30,899 --> 00:16:34,937 families they're from, etc. If you are a human being, you have 210 00:16:35,037 --> 00:16:38,678 a fundamental right to quality care. Indeed, that was one of 211 00:16:38,698 --> 00:16:42,501 the principles of the Affordable Care Act that was passed and 212 00:16:42,562 --> 00:16:46,138 signed by President Obama in 2010. You have a fundamental 213 00:16:46,197 --> 00:16:52,424 right to quality care. That is our responsibility as caregivers 214 00:16:52,424 --> 00:16:56,787 . One of the reasons why this is a bigger problem now than it 215 00:16:56,846 --> 00:17:04,425 was 30 years ago is that, with the expansion of the Health Care 216 00:17:04,425 --> 00:17:09,115 Act and more people coming into the system, the complexities 217 00:17:09,196 --> 00:17:13,233 have significantly increased, and all the more reason for 218 00:17:13,273 --> 00:17:16,652 those of us in leadership positions And basically I'm 219 00:17:16,672 --> 00:17:20,000 talking about a caregiver now, any caregiver, as compared to a 220 00:17:20,039 --> 00:17:23,497 patient. It is our responsibility to solve these 221 00:17:23,617 --> 00:17:28,079 issues, and one of the ways to solve the issue is health equity 222 00:17:28,079 --> 00:17:32,498 , and one of the ways to create health equity is to start with 223 00:17:32,577 --> 00:17:37,316 what I call the person in the mirror. Let's say I'm Dr Chokta, 224 00:17:37,316 --> 00:17:42,276 i'm a general surgeon And I have called to the emergency 225 00:17:42,336 --> 00:17:47,779 room to see a patient. It is my responsibility to go into that 226 00:17:48,481 --> 00:17:51,672 environment with a certain attitude mentally before I even 227 00:17:51,711 --> 00:17:57,538 get there, and beliefs need to lead to thoughts. Thought leads 228 00:17:57,557 --> 00:18:02,892 to feelings and feelings lead to behaviors. And so if I want 229 00:18:02,932 --> 00:18:05,459 things to come out of certain way, i need to start with a 230 00:18:05,499 --> 00:18:09,498 certain attitude before I even get to the emergency room to see 231 00:18:09,498 --> 00:18:15,798 that patient. You would be amazed at how we predict outcome 232 00:18:15,798 --> 00:18:21,632 by our belief systems and by our attitudes. And so if you're 233 00:18:21,673 --> 00:18:25,208 seeing a lot of negativity around you, take a look again at 234 00:18:25,208 --> 00:18:28,778 the person in the mirror and begin to question what your 235 00:18:28,837 --> 00:18:32,978 beliefs are. So what have we learned? in conclusion? 236 00:18:34,130 --> 00:18:38,265 Healthcare disparities is a horrible situation that creates 237 00:18:38,345 --> 00:18:43,416 poor healthcare for a number of people. It leads to mistakes in 238 00:18:43,477 --> 00:18:48,392 healthcare. It leads to less than quality care. We can do 239 00:18:48,432 --> 00:18:51,872 better. We can do better, we should do better, and the best 240 00:18:51,951 --> 00:18:54,523 way to do better is to start with the person in the mirror, 241 00:18:55,067 --> 00:18:59,519 make sure that our beliefs are positive and are in alignment 242 00:19:00,079 --> 00:19:03,538 with our thoughts And our thoughts are in alignment with 243 00:19:03,618 --> 00:19:06,411 our feelings and that our feelings are in alignment with 244 00:19:06,490 --> 00:19:11,316 our behaviors. If we do that on a positive level, we're setting 245 00:19:11,416 --> 00:19:16,297 ourselves up to succeed, and if we succeed, our patients succeed 246 00:19:16,297 --> 00:19:19,458 , because ultimately, we're talking about a relationship, 247 00:19:20,609 --> 00:19:24,571 and relationships are based on three things Mutual respect, 248 00:19:25,053 --> 00:19:29,592 mutual trust and good communication. And even though 249 00:19:29,632 --> 00:19:33,880 this is a relationship, keep in mind that we, and we, the 250 00:19:33,920 --> 00:19:37,733 caregiver, have the authority and the power in this 251 00:19:37,814 --> 00:19:43,713 relationship that the patient does not have. Consequently, we 252 00:19:43,794 --> 00:19:48,395 must take the lead. We have that responsibility to take that 253 00:19:48,476 --> 00:19:53,651 lead and to make sure that the patient does well and receives 254 00:19:53,691 --> 00:19:58,534 the very highest quality of care . One of my friends used to 255 00:19:58,694 --> 00:20:02,269 always mention, when we talk about healthcare quality is to 256 00:20:02,410 --> 00:20:06,136 use the mom test. What type of care would you want your mother 257 00:20:06,156 --> 00:20:10,323 to get If she were a patient who had been in an auto accident 258 00:20:10,383 --> 00:20:13,493 and had a fractured femur and was rolled into the emergency 259 00:20:13,595 --> 00:20:20,599 room? Your approach works for you as fine, as long as you make 260 00:20:20,599 --> 00:20:25,016 sure that your beliefs are positive and fair and honest, 261 00:20:25,930 --> 00:20:30,059 because that will dictate what the result is going to be in 262 00:20:30,099 --> 00:20:34,530 terms of your actions. That is my only conclusion. Our 263 00:20:34,590 --> 00:20:38,259 relationships are based on mutual respect, mutual trust and 264 00:20:38,259 --> 00:20:43,797 good communication. I believe with my basic principles. Number 265 00:20:43,797 --> 00:20:48,431 one God is in charge. I am a physician of faith and indeed it 266 00:20:48,431 --> 00:20:51,977 has been my faith that has sustained me over the years and 267 00:20:52,057 --> 00:20:59,616 has allowed me to do the things that I wanted to do and to 268 00:20:59,656 --> 00:21:04,730 succeed and be helpful in a positive way. My second basic 269 00:21:04,849 --> 00:21:08,823 principle is I don't have any bad days. I decided many years 270 00:21:08,903 --> 00:21:12,394 ago that whether my day was good or bad was completely up to me, 271 00:21:12,394 --> 00:21:16,848 so I decided I didn't have one anymore bad days, and so now my 272 00:21:16,888 --> 00:21:21,557 days are all good or great. Principle number three my basic 273 00:21:21,577 --> 00:21:25,131 principles I don't sweat the small stuff, and most stuff is 274 00:21:25,171 --> 00:21:29,579 small. What I have learned is that when I get upset or about 275 00:21:29,619 --> 00:21:33,377 to get upset about something, nine times out of ten it's going 276 00:21:33,377 --> 00:21:36,128 to be something that's relatively small, it's going to 277 00:21:36,148 --> 00:21:39,436 be something I can let go and it's not that big a deal. And 278 00:21:39,517 --> 00:21:44,012 I've learned to pause and go more slowly. Don't do it all the 279 00:21:44,012 --> 00:21:48,208 time, but I'm better at evaluating those situations than 280 00:21:48,208 --> 00:21:53,281 I used to. Principle number four forgiveness is therapy. 281 00:21:54,244 --> 00:21:56,851 Many times in life, certainly in healthcare, whether it be a 282 00:21:56,892 --> 00:22:00,039 patient or whether it be a fellow caregiver individuals 283 00:22:00,079 --> 00:22:04,295 will say or perceptibly do things to you that you believe 284 00:22:04,395 --> 00:22:09,432 were not in your best interest. My suggestion to you is to 285 00:22:09,511 --> 00:22:12,726 forgive them. Has nothing to do with who's right or wrong, has 286 00:22:12,766 --> 00:22:16,675 nothing to do with the facts. Just forgive them and you would 287 00:22:16,695 --> 00:22:21,530 be amazed at how not only that is empowering for you, but how 288 00:22:21,651 --> 00:22:25,641 therapeutic that is for you as you move forward and try to make 289 00:22:25,641 --> 00:22:30,935 the world a better place. And basic principle number five that 290 00:22:30,935 --> 00:22:33,981 we've been talking about already everything is a 291 00:22:34,041 --> 00:22:38,297 relationship. Everything is a relationship. Today we talked 292 00:22:38,336 --> 00:22:42,672 about the caregiver-patient relationship, but my suggestion 293 00:22:42,712 --> 00:22:45,478 to you, whether it's doctor-patient, whether it's 294 00:22:45,878 --> 00:22:50,974 husband and wife, parent, child co-worker, co-worker, boss, 295 00:22:51,655 --> 00:22:55,343 employee relationships are based on the same thing mutual 296 00:22:55,363 --> 00:23:00,358 respect, mutual trust and good communication. If you have those 297 00:23:00,358 --> 00:23:04,636 three things, you have a strong and a viable relationship. If 298 00:23:04,696 --> 00:23:09,372 you do not, then you need to work on the areas of how, work 299 00:23:09,432 --> 00:23:12,680 on the areas that you can improve to get that relationship 300 00:23:12,680 --> 00:23:17,476 to where it should be. Final thought be the change you want 301 00:23:17,496 --> 00:23:22,291 to see in the world. Be the change you want to see in the 302 00:23:22,352 --> 00:23:23,900 world. Have a great day. 303 00:23:24,644 --> 00:23:26,452 Speaker 1: Thanks for listening to the Healthy, wealthy and Wise 304 00:23:26,452 --> 00:23:31,548 podcast with Dr William Choctaw , mdjd. We hope you enjoyed this 305 00:23:31,548 --> 00:23:34,461 episode and, if you found it helpful, you can support and 306 00:23:34,500 --> 00:23:37,993 subscribe to the podcast on your favorite podcast platform. Look 307 00:23:37,993 --> 00:23:42,145 at the words, dr William Choctaw, click on the. Support 308 00:23:42,165 --> 00:23:46,936 the show and you've got it. This will also help ensure that you 309 00:23:46,977 --> 00:23:50,932 don't miss any future episodes, and then share this podcast with 310 00:23:50,932 --> 00:23:54,488 your family, friends and all your co-workers. They'll be glad 311 00:23:54,488 --> 00:23:58,811 you did So. Until the next time , live your best possible life 312 00:23:59,112 --> 00:24:00,432 the best possible way.