Patient-Doctor Discussion #2

A patient talks about vaccines and long-term relationships.

What is The Clinical Excellence Podcast?

The Clinical Excellent Podcast, sponsored by the Bucksbaum Institute for Clinical Excellence is a biweekly podcast hosted by Drs. Adam Cifu and Matthew Sorrentino. The podcast has three formats: discussions between doctors and patients, discussions with authors of research pertinent to improving clinical care and the doctor-patient relationship and discussions with physicians about challenges in the doctor-patient relationship or in the life of a physician.

[00:00:00] Dr. Cifu: On today's episode of The Clinical Excellence Podcast, we have Stephanie Collins.

[00:00:09] Ms. Collins: So I think you need to be kind of honest and patients need to really open up, explain their fears, and just, if I'm just feeling lousy, whatever, I think there just needs to be some honest communication.

[00:00:30] Dr. Cifu: We're back with another episode of The Clinical Excellence Podcast sponsored by the Bucksbaum Institute. During this podcast, we discuss, dissect, and promote clinical excellence. We review research pertinent clinical excellence. We invite experts to discuss topics that often challenge the physician-patient relationship, and we host conversations between patients and doctors.

I'm Adam Cifu, and today I'm joined by one of our patients, Stephanie Collins. Stephanie is a retired public school educator, but we were joking that she has redefined retirement and all of the things she does both professionally and I don't know, personally. So Stephanie, thank you very much for coming in today.

[00:01:09] Ms. Collins: Thank you for inviting me.

[00:01:10] Dr. Cifu: My opening question is kind of a boring one. It's one I've used before on the podcast and it's very general. Um, what have you found sort of in your time, you know, interacting with the medical system that you find is sort of good about the medical system, that you'd kind of compliment our American healthcare system for, and then what are the things that have kind of, I don't know, irritated you about it that you'd say, boy, this I'd like to change?

[00:01:35] Ms. Collins: Well, you know, I have been involved with this particular healthcare system since I was 17 years old, we're talking about 50 years, but one thing that I like about it, I feel like the medical care is very good. I like the fact that when I need to see a specialist, I can be referred to someone here so I don't have to go running all over the city.

But the one thing that I'm sort of irritated about is the emergency room, because about, it's almost been a year that I was in the emergency room and Dr. Cifu called to let them know I was coming because I was very, very sick and I sat literally in the emergency room for 24 hours. 12 hours in the lobby being uncomfortable and then finally went into the triage and I was there for another 12 hours, but at least I was sleeping on a gurney.

And, you know, the treatment started and then they found a room. So that was the one experience, because I don't really come to the emergency room.

[00:02:48] Dr. Cifu: I guess I can kind of broaden that out and it's kind of like what a lot of people say, you know, not just here, but about like American healthcare in general, right?

We talk a lot about the importance of having like a medical home, right? A place that you feel like you can get your care. But boy, emergency medicine can be tough and especially in an area like we live in, um, where there aren't as many hospitals as there used to be. And so, you know, the hospitals that we do have tend to be overwhelmed with emergency care.

[00:03:16] Ms. Collins: Exactly. Exactly.

[00:03:18] Dr. Cifu: So, um, my second question is really what made me want to have you on and when we were first planning this podcast, you were like one of the first people who came to mind to invite because of a very, I don't know, telling, but also very honest message you sent me back in the fall of 2020.

UFC, like many institutions had, uh, Covid vaccine trials and we were actually having trouble filling all our spots. And I sent out a sort of auto message to a bunch of my patients, and your response to me on the Epic MyChart system was, "Thank you for thinking of me, but I will pass this time because of historical issues around the use of African Americans in trials." And I remember being like, yep, I could see Ms. Collins writing that.

[00:04:02] Ms. Collins: Yeah.

[00:04:03] Dr. Cifu: But also I was really impressed with your sort of openness and honesty. Um, and I'd just love to hear kind of your thoughts, um, you know, as you got that email and sort of response to it.

[00:04:14] Ms. Collins: Well, I trust you. I feel very comfortable with you.

I think you're very open and honest with me. The one thing I really like is when we have to adjust and change medications and I'm saying, "Ugh, I don't know. Can we try this?" You are always willing to say, "Okay, let's do this," but if it has gone too long, you will say, "Okay, this is too much. We're going to have to do X, Y, and Z."

So I just felt like I could just be very honest with you. And I also figured you were the type of person that knew exactly what I was talking about. So, because, um, when they first started working on the vaccines, I said I wasn't going to get it.

[00:05:01] Dr. Cifu: Yeah, yeah.

[00:05:02] Ms. Collins: And it took a couple of months, I mean, I was quarantined and I did everything I was supposed to do.

[00:05:08] Dr. Cifu: Right.

[00:05:08] Ms. Collins: Stay in, but then I was watching a lot of webinars from different doctors, male, female, black, white, other nationalities. And then I said, "Okay, I think I'm going to take that step." And then I asked you and you said, "Oh, I just got mine. And you know, I felt a little wonky one day and had to go home, but other than that, I was fine." So I said, "Okay, I'll do it." So, and I had absolutely no problems.

[00:05:39] Dr. Cifu: That's great.

[00:05:40] Ms. Collins: My arm might have been sore that day, and the next day I forgot that I had a shot. So I was good.

[00:05:47] Dr. Cifu: It was such an interesting time because I think how people felt about getting the vaccine was so mixed up in so many of our feelings, right?

[00:05:57] Ms. Collins: Mm-hmm, mm-hmm.

[00:05:58] Dr. Cifu: It happened so fast. There was such weird divides of people who were, um, you know, who were suspicious of things that weren't generally suspicious of things, and other people who were accepting of it, who weren't really accepting of it. And then all of the issues about how, you know, the death rates and illness sort of broke down among various, you know, parts of the population and, you know, obviously we're in Chicago and Chicago had just unbelievable differences, you know, from one neighborhood to another neighborhood six miles away. Um, and it was striking how people responded to the illness and the, I don't know, the threat maybe.

[00:06:36] Ms. Collins: You know, and it also made me start thinking, because I remember as a child, I have the scar from a polio vaccine on my shoulder and all the other things that I had to take as a kid. So I said, "Well, I'm still here."

[00:06:50] Dr. Cifu: Yeah.

[00:06:51] Ms. Collins: And you know, we have eradicated, even though sometimes some of the things have come back, but I said things like smallpox and polio and this and that and the other. So, and after listening to all these doctors, I said, "Okay, I'm going to do it."

[00:07:03] Dr. Cifu: Yeah.

[00:07:03] Ms. Collins: And I did.

[00:07:04] Dr. Cifu: I think of our childhood response to vaccines because I think, you know, our parents, they lived through all those diseases, right? And so I think for them, there was basically zero thought about not getting a kid vaccinated because, you know, my aunt had polio and so my parents were like, "Of course we're going to get you vaccinated."

[00:07:27] Ms. Collins: Yeah. Yeah.

[00:07:27] Dr. Cifu: And it's a little bit different now where we've had 50 years of, I don't know, not being infectious disease free, but kind of close to it.

[00:07:35] Ms. Collins: Yeah. Yeah.

[00:07:36] Dr. Cifu: Um, so listen, you've been in the patient role for a long time. I've known you in the patient role for a long time. Um, we got a lot of listeners who are patients, a lot of listeners who are doctors, are there just sort of advice that you'd give mostly to the physicians, you know, caring for people, you know, what have you seen that's worked well? What have you seen that hasn't worked well? Are there things you do?

[00:07:58] Ms. Collins: I think that physicians have to really, really listen and especially be sensitive to fears of the patient, which is what you do, because I remember you even said, "If they are going to make you do a colonoscopy in the hospital and you don't want that, you want the virtual colonoscopy," you said, "I'll talk to them," and I'm like, "That's my doctor." So I think you need to be kind of, um, honest and uh, I think patients need to really open up, explain their fears, explain what's wrong with them, don't hide it, you know, and just, if I'm just feeling lousy, whatever, I think there just needs to be some honest communication and listening.

And I also like the way you explain how things work or how this medication is going to work. And I always know I can call you.

[00:08:57] Dr. Cifu: Are there things that you think get in the way of people expressing those fears? Because I mean, we all have those fears, right? I mean, when I'm on the patient side of things, I know what I'm worried about and sometimes the doctor picks up on it, other times not. Um, I kind of ask you as an educator, you know, like, it's almost how can you, I don't know, teach doctors or teach patients how to, you know, how to get that stuff more out in the open.

[00:09:27] Ms. Collins: I don't know. That's a good question. And maybe it's because I have been coming to you for so long because it's been over 25 years.

[00:09:35] Dr. Cifu: Don't say it, you'll date both of us.

[00:09:37] Ms. Collins: Yeah. You were fresh out of school when you came.

[00:09:40] Dr. Cifu: I was 12 years old.

[00:09:41] Ms. Collins: Exactly. And, uh, I just think it's my comfort level, and just being able to have conversation, because sometimes we'll touch on something that has nothing to do with doctoring, you know, like, how's your mom? How's your grandson? You know, the personal things.

[00:09:58] Dr. Cifu: Yeah. Yeah.

[00:09:59] Ms. Collins: So kind of personalize.

[00:10:00] Dr. Cifu: Well maybe that's an important thing because I mean that's sort of underlining the importance of, you know, an ongoing relationship which is probably, I mean, which is less common with our population being more mobile and with all the issues of changing insurances and things like that. Um, and that maybe just one of those things that, you know, we in Madison need to concentrate on as much as possible.

[00:10:23] Ms. Collins: Yeah. And I remember two instances when you talked about your children, and I think at that time I didn't even know you had children.

[00:10:29] Dr. Cifu: Yeah.

[00:10:29] Ms. Collins: One was that your son used to love bananas and he ate so many bananas that you said he was starting to curve and turn yellow. And then your daughter had a teacher who had dreadlocks and she told you, "Dad, I want hair like Miss whatever her name is." And you tried to explain to her your hair doesn't do that...

[00:10:53] Dr. Cifu: That's right.

[00:10:53] Ms. Collins: But she wanted that hair, so that kind of made it personable. You know, like you're a human, you have a family, so...

[00:11:02] Dr. Cifu: I remember that because I said that she said she wanted hair like you had.

[00:11:05] Ms. Collins: Okay.

[00:11:06] Dr. Cifu: And I said, "You know, you're never going to have hair like that because you got stringy white girl hair."

[00:11:10] Ms. Collins: Yeah. So it's that kind of stuff. And I even brought my grandson when I had him.

[00:11:15] Dr. Cifu: He was little in a stroller.

[00:11:17] Ms. Collins: I rolled him in.

[00:11:18] Dr. Cifu: I remember that.

[00:11:19] Ms. Collins: And it was, you know, it was really no biggie, like, "Okay, just bring the family on in."

[00:11:23] Dr. Cifu: Yeah.

[00:11:24] Ms. Collins: So I think that helps, that does.

[00:11:26] Dr. Cifu: Well, Ms. Collins, I really appreciate you coming in, taking the time for this, especially since I stood you up the week before. Um, and this was great because just exactly what I wanted as far as a conversation.

[00:11:37] Ms. Collins: Well, thank you for having me. My first podcast.

[00:11:41] Dr. Cifu: Thanks for joining us for this episode of The Clinical Excellence Podcast. We are sponsored by the Bucksbaum Institute for Clinical Excellence at the University of Chicago. Please feel free to reach out to us with your thoughts and ideas on the Bucksbaum Institute Twitter page.

The music for The Clinical Excellence Podcast is courtesy of Dr. Maylyn Martinez.