Today’s guest is Hannah Bertrand who brings an oncologist’s perspective on healthcare to the Perspectives on Healthcare Podcast with Rob Oliver. Hannah is a member of the Millennial Generation
(Generation Y.) She practices medicine in Germany where she is a resident in internal medicine with a subspecialty in hematology and oncology. It is great to get her perspective, not just because she specializes in an area that has not been covered much, but also because she brings a European medicine viewpoint.
Here are 3 points that stood out as Hannah Bertrand shared an oncologist’s perspective on healthcare:
· Myeloproliferative neoplasms are a group of diseases that can be predecessors to leukemia. By looking at these indicators, there is a possibility of taking some preventative measures related to leukemia.
· Quality healthcare in an ideal world means that everyone has access to healthcare as well as high-quality treatment.
· We need to humanize healthcare and put the patient right at the heart of healthcare. That’s how we improve healthcare quality!
You can connect with Hannah Bertrand through the following links:
Here is the transcript of Hannah Bertrand: An Oncologists Perspective on Healthcare:
Introduction to Hannah Bertrand
Rob Oliver: Thank you and welcome to Perspectives on Healthcare. Today’s perspective comes from Hannah Bertrand. She is from Germany. She is a resident in hematology and oncology. She is a member of the millennial generation. Hannah, welcome to the podcast.
Hannah Bertrand: Hi Rob, so nice to meet you. Wonderful, so tell me a little bit about yourself and your role in healthcare, please.
Hannah Bertrand: Well, as you said, my name is Hannah Bertrand. I’m 31 years old and I am currently a third year resident in internal medicine. And my subspecialty is hematology and oncology. So my role right now as a resident, I am currently in the ER because that’s part of our rotation in internal medicine. So that’s new to me for like a week now. And as a resident in oncology, I’m focusing on research. I’ve just currently started my own funded research project within a PhD program. And that’s really exciting. I’m really excited about oncology research because there’s still so much to discover about cancer and its treatment.
Rob Oliver: Okay, so is your course of study an MD-PhD combination or how does that work?
Hannah Bertrand: So I think it’s a little different from how it happens in America, MD-PhD program. And we call this a clinical program that we’re in. Yeah.
Rob Oliver: Okay.
Hannah Bertrand: So clinical researcher, we actually call it because it’s a combination of working in the clinic and having our rotations and then having our own funded programs and working towards MD-PhD.
Rob Oliver: Okay. So is there a particular area of cancer that you are looking at?
Hannah Bertrand: Yeah, I’m actually focused on leukemia and all the diseases that come prior. So, there’s a certain group of diseases called myeloproliferative neoplasms. That’s a word in itself, but it basically means that there’s blood cells that are just duplicating without any form of restriction. And this itself is not malignant, but it can lead to acute leukemia. And we want to treat these diseases before it actually comes to leukemia.
Rob Oliver: Okay. So what I’m hearing you say is you’re working on kind of the, the signs that are showing up beforehand that leukemia is, is coming and seeing how you can treat that before it actually comes to fruition. Is that proper understanding?
Hannah Bertrand: Yes. Yes, that’s correct. So there is mutations that we’re looking at that we know if they occur, these prior diseases can cause and if the mutations appear in the system of the patient, it’s more likely that leukemia can occur. So we’re actually looking at these mutations and trying to treat them before it actually comes to the leukemia.
Rob Oliver: Okay. So how do you encourage people? to get a proper screening for this? Is it something that if there’s a history of leukemia in the family, then you would want them to get screened for this? Or is it something that the general public should get? Or what are the indicators that say, you need to get this screening for pre-leukemia?
Hannah Bertrand: So that is actually a very, very problematic factor because we don’t have a very good screening system. Yes, if you have leukemia in the family, you definitely should get better screenings. And some hints as well, like having an enlarged spleen, for example, or having abnormal blood parameters. I think that’s the most likely that you can see from your primary care doc, for example. And if that, if there’s abnormal blood parameters, you can just go check and see a hematologist, oncologist, and just make sure that there’s nothing happening that shouldn’t.
The Hannah Bertrand definition of quality healthcare
Rob Oliver: Okay. Thank you for explaining that. What does quality healthcare mean to you?
Hannah Bertrand: So there’s different aspects of this. First of all, in my ideal world, that would be that everyone had access to healthcare. I think that’s a very big point because so often it depends on how much is in one’s pocket or in what area of life of the world you’re from or what your different or what your background is so just having access to health care in general and then also having access to high standard treatments. So talking about leukemia there’s a lot of very expensive medicine and it would just be ideal if. there would be newer drugs that would just treat the diseases better and everyone had access to it. I mean one aspect that we can definitely implement right away is just humanize health care a lot more and just putting the patient a lot more to the core of health care because so much it’s about efficiency and cost reduction and we don’t have enough staff. but just being realistic about what it’s actually about that’s the patient.
Rob Oliver: Okay. I think you kind of did this already, but can you give me an example of quality healthcare?
Hannah Bertrand: So an example of everyone having access to is actually happening here in Germany because we have, so for Germans, it’s mandatory to have health insurance. And I think that is a start at least so that everyone has access to the basics. We’re giving an example on how people can have access to high standard treatments. It’s actually from my clinic. So we have a unit which is called early clinical trial unit. So you see when there’s a new drug, it has to be tested first with cells and then it has to be tested. on animals and then it has to be tested on human when we know it’s safe enough to have a clinical trial. And people with cancer, for example, that’s difficult to treat, they get access in our early clinical trial unit if they fit and all the factors fit that they can be enrolled. So that’s a great, I think a great example. And like also within oncology, it’s that implementing a team of healthcare professionals that’s not only doctors and nurses. So I think that’s a good example of quality healthcare because looking at the patient, it’s not only the disease, it’s also the psychologist, it’s the nutrition. There’s so much more and just covering up every aspect of the patient so you can just make it as good as possible for the one you treated.
Rob Oliver: Okay, so talk to me a little bit about the German healthcare system if you don’t mind. You said everyone must have health insurance. privately funded health insurance that they’re paying for out of their pocket? Is it government funded health insurance or what’s the what’s the payer for the mandatory health insurance?
Hannah Bertrand: Yeah, thank you for that question. So we have two like two way system. So first of all, we have the basic or the like the health care that is generated for everyone. And part of it you pay depending on your salary. And the other part is your employee paying. So the employee and the employee pay part of it. And it’s also government funded, of course, because if there’s like super expensive drugs that you would need, for example, having leukemia, you couldn’t pay for all of it. So there’s part of it taken care of by the government. And then there’s also private health insurance. So for everyone being above a certain salary level, so everyone who is self-employed, for example, doctors, lawyers, there are certain groups of people that have private health insurance. And I mean, there’s also a controversy about this, because if you call a doctor, for example, and you’re privately insured, you get an appointment. appointment which is like you get it way easier than people who are just having the basic health insurance But I think in general, it’s just very good that um, everyone has access to it.
Rob Oliver: Okay, so What i’m hearing is that there is a base level where everyone has coverage and then you’re able to get kind of another form of health insurance above and beyond that and My my understanding because I’ve talked to people from around the world. And the understanding is that socialized medicine concept is excellent when it comes to general healthcare. So you have the access that you’re guaranteed to see somebody because it’s covered. What you’re talking about is the timeliness of that access. So some people, when they’re called, because of the nature of their health insurance, are able to get in quicker than other people. And… I completely agree with and understand what you’re saying that there seem, because here I’ll be upfront about this. We just had a interview a couple of weeks ago with someone who deals with Medicare, which is our kind of socialized medicine for old people in the United States. That’s way oversimplification. But anyway, we were talking about the fact that here in the United States, one of the first questions that’s asked when someone is going into treatment is what kind of insurance do you have? And in that way, the insurance company is determining a lot more about the nature of your treatment plan than the medical professional is. And it sounds like over in Germany, you don’t have that exact thing, but there is an element of which the speed with which you are treated and the access that you have to the whole arena of treatment options is determined in some way by the insurance that you have it. Is that properly framing it?
Hannah Bertrand: I think, like overall, it frames it pretty, pretty properly. So I’ve heard of Medicare and its problems. I think I would compare it, maybe our system is not as extreme. So, I mean, I’ve heard of people coming to the ER because they have an urgent medical condition that needs to be treated. Otherwise, it would have been treated if somebody had health insurance. So for example, people who were patients who need dialysis, they come to the dialysis three times a week. And I’ve heard that from a hospital when I visited a friend in the States and she’s a doctor too. She told me that, yeah, we have patients who come to the ER and need like emergency dialysis because they don’t have a place because they’re not health insured. So that wouldn’t happen over here. Got it. But still I think in a way it’s the same but maybe not as extreme. So you get easier access and you get like your appointments are a lot closer to you actually having the problem that needs to be treated. And also, somehow that how much time is spent with the patient, for example, and also the practice is a problem is that if you have a private practice, for example, you get a lot more money for privately insured patient. So think you’re you know where I’m getting at. So it I think it happens in a similar way, but not as extreme that, you know, people are like send away or they don’t have access to it at all.
Rob Oliver: Yeah. And over here, we do have a safety net that says, hospitals cannot turn away somebody because of lack of insurance. So that’s important as well.
Understanding the role of an oncologist
Rob Oliver: What do you wish people understood about your role in health care?
Hannah Bertrand: Well, that is not as bright and shiny as medical TV shows sometimes display it. So I’m not only treating one patient at a time, for example. No, seriously, understanding that we literally do everything to help everyone in need. And sometimes like right now working in the ER, people have to wait a lot. And if somebody thinks they’re waiting too long, I’m just always telling them, congratulations, your medical condition is too good to be treated right away. So everyone’s just trying to understand that if a doctor doesn’t have time for them or not as much as they wish to, it’s simply because somebody else needs it a lot more at this moment. So just being more patient with everyone working in the system because we don’t have enough staff, I think that’s the same problem everywhere. And yes, just because it’s also we have way too much to do with documentation. So I think that’s a big problem that can definitely be improved because we’re spending way too little time with patients.
Rob Oliver: Got it. And yeah, the nice thing about watching a program on TV is that whatever the condition is, the whole thing gets resolved within about an hour, you know, it it’s all taken care of as opposed to the reality that it usually is not resolved in an hour. And the likelihood is that there’s going to be follow up after that and other appointments that are not glamorous and fantastic and are not like anything that you’ve seen on television. I love your point. Thank you for sharing that idea.
Hannah Bertrand: Exactly. Yeah, that’s so true.
Looking to the future of healthcare
Rob Oliver: What excites you about the future of healthcare?
Hannah Bertrand: Well, I think one aspect comes from me being an oncologist and hematologist because it’s personalized medicine. So we know a lot more than we knew a decade or two decades ago. We just had these general chemotherapies or general treatments. And we are getting a lot more into the direction of just finding targeted medicine. And that means you target the cancer cells, so the cells that are sick that have to be gotten rid of. And you don’t affect the healthy cells so much. So just knowing a lot more and improving treatments and just also making screening methods a lot better. I think it’s a long way to go because for a lot of cancer versions, there is just simply no good screening system. But…
Rob Oliver: Yeah. Again, I find it fascinating. One of the keys to cancer treatment is cancer prevention or at least early detection. And that’s where the screening process comes in. And I think you’re spot on with the fact that the screening process needs to be improved so that the treatments that are needed are not as extensive as they would be once the cancer is further progressed than if you had detected it earlier. What’s your thought on that?
Hannah Bertrand: Well, first of all, what came to my mind right now is that this is the… part we can do as medical professionals. But I think what everyone else out there should also consider it’s just what can I do to just prevent all this. So having a healthy lifestyle is so well known, but still there’s so many people who are not like following the right diet or exercising regularly. It’s not about being extreme, you know, and it’s not about like avoiding sugar all along. It’s not about that one ice cream that you have on like nice summer day. Um, but just trying to be aware of your health and most people are only aware of it when it’s gone. So just being a very grateful for my health and everything. I mean, I’m reminded of that daily and I’m trying to like be on the other side and trying to make screenings a lot better. And, um, a combination of that is just being aware of your body. So trying to, for example, avoid breast cancer. There’s methods trying to be implied for everyone, just trying to find a nodes or lymph nodes or abnormal, just trying to know your body very well so you know when something’s not right and just not try to ignore it, but rather see a doctor. There’s, I think, two kinds of people. There’s one kind of people that are just going to the doctor when, you know, with everything that’s abnormal. And there’s a kind of people that are not going regardless of, you know, anything that’s not the way it should be. So, I mean, as a doctor, I have to say, I rather like people to come in, like, one time that it wouldn’t be necessary, but we just check that everything’s okay.
Rob Oliver: Got it. All right. Last question for you.
An idea of for improving healthcare quality
Rob Oliver: What is one thing that medical professionals can start doing today to improve the quality of healthcare?
Hannah Bertrand: Well, I think be united and stand up for everyone working in healthcare because we have to just work together very closely and communicate well. So communication is definitely key. And just also speaking about it like we do now, I think it’s also very important to just raising awareness of health and how we can improve health in general.
Rob Oliver: Wonderful. Hannah Bertrand, thank you so much for being with me today. I appreciate you sharing your thoughts. I appreciate and respect your perspective on healthcare.
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Disclaimer: All opinions expressed by guests on the Perspectives on Healthcare Podcast are solely the opinion of the guest. They are not to be misconstrued as medical diagnoses or medical advice. Please consult with a licensed medical professional before attempting any of the treatments suggested.