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Julia McMichael: A Patient’s Perspective on Healthcare

We get a patient’s perspective on healthcare from Julia McMichael on this episode of the Perspectives on Healthcare podcast with Rob Oliver. This is interview 54 in the patient’s perspective interview marathon. Julia is from New Jersey. She shares an interesting perspective as it relates to both her personal and professional experiences.

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Here are 3 things that stood out as Julia McMichael gave us a patient’s perspective on healthcare:

  • Healthcare heroes are medical professionals who can keep their composure during stressful situations. Their resilience and self-control help provide emotional support for the patients they serve.
  • Quality healthcare is more than meeting quality metrics. It requires a holistic approach with a focus on long-term well-being.
  • Practitioners can improve the quality of healthcare patients receive by taking the time to ensure that patients feel heard.

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Here is the text of Julia McMichael presenting a patient’s perspective on healthcare:

Introduction to Julia McMichael

Rob Oliver: Welcome to the podcast, my friend. We’re going to start with the easy question, and that is, what is your name for everyone out there?

Julia McMichael: My name is Julia McMichael and I live in New Jersey.

Rob Oliver: Excellent. Julia, I appreciate you joining me, and we’ll start right in with the interview, and that is, can you tell me a little bit about yourself and your experience in healthcare?

Julia McMichael: Yeah. I am currently a stay-home mom of four young kids, six, five, three, and almost two. While having them, I also got my bachelor’s degree in healthcare service administration, and I worked in the healthcare field on the administration side for just about 10 years. I quit when I had my fourth baby. I finally said, my hands are full. I worked in family medicine, and then I got to work on the corporate side where I was going into other practices all over the tri-state area, and I was checking in on their quality control, and if they were meeting metrics for their different insurance companies. I also got to train offices about their workflows and how to get a patient more efficiently through the office in a quicker manner. Then I also got to go on the other side, and I got to do all the scheduling for four practices and 28 providers, and do all the data analytics for all their appointment efficiencies and things like that. Then I also get to be an advocate for myself, and my husband, and my four children, and all their healthcare involvements, and then I often in helping family and friends understand their healthcare benefits when they’re choosing for work or whatever because it seems to be overwhelming and confusing.

Rob Oliver: Okay. You must have a huge hat rack because you have a ton of different hats that you wear. I’ll just say that your work in inefficiency and helping practices understand how to get patients through the office as quickly as possible. We need to clone you on that and send you around because how many of the complaints that people have is, I had to wait so long. Then it’s a double-edged sword because you say, I had to wait so long and then they didn’t spend very much time with me. It’s that the more time they spend with you, the longer the next person is going to have to wait. Can you talk about the logistics of how you expedite the patient flow and yet maximize the amount of time that the medical practitioner is spending with the patient? Does that make sense as a question?

Julia McMichael: Yeah, it does. I think it first starts with your EMR system, your electronic medical record system. If you’re not using paper anymore, which most people have moved to electronic medical records, is your system efficient? Does it work with your workflow? Then it also comes down to the patient’s care starts the moment that patient’s name is called. Once they check in, it’s starting. So you are utilizing your medical assistance to bring them back to take all the necessary things, their blood pressure, their temperature. Are you getting all of that done, tracked and out of the way? Is the nurse coming in or the medical assistant asking and addressing not only the issue they’re there for today, but then utilizing some time to check in. Okay, have you gotten your colonoscopy? Have you gotten your mammogram? Asking all those questions to get them out of the way so that when the provider’s in there, he can now discuss what’s going on and see a better full picture because the information has already been stored there. So that when the provider comes in, he’s not taking or she or he is not taking that time to ask you those basic questions that a medical assistant or someone else can do. The more questions he has to ask you to get to the issue, the more of the time of that provider that’s getting eaten up.

Rob Oliver: Okay, so help me with something though, because it’s good to have somebody ask all those questions and put all that information into the EMR, into the electronic medical record. But how do you help the doctor as he comes into the room not to have his nose in the iPad or the, yeah. So because I mean, he needs to get the information, but sometimes it’s almost like the information in the computer becomes more important than connecting with the patient. Do you understand?

Julia McMichael: Yes, I understand.

Rob Oliver: So how do you help him or her?

Julia McMichael: I think it comes down to the way the screen is interfacing to the provider. What are they seeing? Are they having to make multiple clicks? I know that when we were working with different doctors, the main complaint was I have to click in so many different spots to see all that I need to see. So it’s bringing all of those main things that the provider has on their mind when they’re walking into the room, all to one screen. So when they open it up, you see green or red or yellow, meaning something’s coming up to be due. Red, it is not due, this patient’s not getting it done. Green, everything’s clear, we’re good. So that they can see the issues and the things that they need to address right away. Now that breaks into quality metrics, which is a whole nother thing that I will get to in quality healthcare.

Recognizing a Healthcare Hero

Rob Oliver: Sounds good. So along the way, have you met anyone that you would classify as a healthcare hero?

Julia McMichael: I think my healthcare hero was actually my OBGYN. Like Ali said right before me, when my second child was born, she didn’t breathe for the first five minutes. And my OB kept the room very calm and relaxed. I think she knew, I think she was nervous. Rob and I were very nervous. The staff was nervous. But the way she handled it, the way she communicated with the other staff in the room, when NICU came in, she controlled the setting. And when Mackenzie finally decided to take a breath and breathe and scream, she immediately got up, embraced my husband, came over, kissed me on the cheek and reassured us that everything was okay. And we all just kind of took that big relief, but she became a human in that moment. But the whole time she was making sure that the mood was controlled and that she didn’t rev up our emotions to start thinking of all the possibilities of what that could mean of her not taking a breath.

Rob Oliver: Yeah, that’s amazing. And what a powerful statement for her. And you said that she was likely nervous and worried, but not letting that affect the way that she did her work and the way that she was… I’m gonna put words in your mouth and you can tell me whether or not I’m wrong, but that she was kind of like a solid rock of foundation, not being driven around or not be not movable or just a calming influence. Would those be accurate?

Julia McMichael: Yes, she was very steady.

Defining Quality Healthcare

Rob Oliver: All right. So what does quality healthcare mean to you? And I’ll just be quiet because I’ve been waiting for this answer.

Julia McMichael: Okay, so quality healthcare to me, it definitely goes beyond the insurance quality metrics. And the main reason I say that is because a big part of my job was going in and checking that everyone was hitting their quality metrics because when they hit their quality metrics, guess what? They got a big check. If I’m working for you as the office, I wanna make sure that you’re gonna get your check. I wanna make sure that you’re checking all your quality metrics. But quality healthcare is not just checking a box. It’s when the provider listens to the patient’s concerns. It’s when the provider is assessing the patient as a whole, which a lot of times that means you need to look into the patient’s lifestyle. You need to look into the patient’s environment. You need to look into who and what is taking care of this patient. It then also goes into fluid communication between your primary care and any specialists that you have involved, which is so important that your whole healthcare team, however many providers that involves from any different healthcare areas, that they’re all on the same path and have the same goal in mind to help this patient reach an optimal form of living. So often that means being willing to look at other options and just medication and see, what else can we do for the patient? What about their diet? It’s not always just looking, give a quick fix. And I think that communication around the whole board of who’s caring for this patient can make a big difference.

What Should Your Medical Providers Understand About You?

Rob Oliver: Yeah, very, very well said. So what is one thing or what is something that you wish your medical providers understood about you?

Julia McMichael: I think I’ve had a couple of instances. I struggled with postpartum depression after my third pregnancy. And then after I had my fourth baby, we decided we were gonna take a break from having kids. And I really struggled with my hormones just being out of balance and trying to figure that out and what that meant. And in both of those circumstances, when I finally had the courage to address the fact that I was having an issue, I felt like the overall response was, oh, a lot of people go through this, so here you go. Here’s how we’re gonna fix it. And I felt like I was so overwhelmed in those moments because I was emotionally having a really hard time that I was just like, whatever, we’ll fix it, please. And instead of talking it through and asking more questions and seeing my options, I just felt like something was thrown at me because it worked for the general, but I’m not everybody else. And I want to be looked at as an individual. And I think then I have come back and advocated for myself and said, hey, this doesn’t work for me. I actually don’t wanna do this and I need to find other options. And I did do that when I had the postpartum depression and found another avenue that worked for me, but I had to fight for myself. So I think sometimes I just wish I wasn’t just put into a category that we were always looked at the whole picture of an individual.

Rob Oliver: Yeah, so I think what I heard you say in there is like, I don’t wanna be fixed, I wanna be heard. Did I, did I probably, or did I miss it? And you were saying like, I don’t care what it is, I don’t wanna feel like this anymore, fix me. Where would you kind of-

Julia McMichael: I definitely felt those ways at those times. Like I don’t wanna feel like this anymore, but I also didn’t want a quick fix. I wanted a lasting fix. And so I think often both of those instances I was just thrown medicine and they didn’t work for me. And then I had to start back on square one. So I don’t wanna just have the quick fix. I don’t wanna meet, I wanna do put in the work if I need to to make sure that my overall long-term health then is getting better as well.

A Strategy for Improving Healthcare Quality

Rob Oliver: Okay, excellent. What is one thing medical professionals can start doing today to improve the quality of healthcare?

Julia McMichael: So I think my first thought is don’t rush. I understand that you cannot spend an hour with every patient, like we were saying, but it just backs up the whole schedule. But I’ve been in positions where companies are pushing to see six patients an hour. And I just think it starts to get ridiculous. And with the pressure of insurance companies, it becomes, are they hitting their qualities? What’s the analytical data? And when you start to view your practice that way as a provider, I think you’re losing out on why you’re practicing medicine in the first place. So I just think like allow your patients to feel heard. And I think that comes to figuring out a workflow that works for you so that you as the doctor can be connected in your winner each in every appointment. And like you said, being away from the screen, having that connection with the patient and making them feel heard and utilizing your staff. I think we need to train patients. And I’ve learned this from being in the work environment that a nurse practitioner or a PA or a nurse or a medical assistant, they are all there to help you as a whole. Not everything just has to come directly from the doctor. So we as patients also need to learn how to utilize those staff members and the doctors and other providers need to utilize the staff as a whole so that the patient can get the full experience.

Rob Oliver: Okay. You said a number in there and it came out real quick. How many patients are they trying to get them to see an hour?

Julia McMichael: I was in a circumstance where they want six patients seen an hour.

Rob Oliver: Okay. Like that’s, you can barely get in the door and like say hello and shake hands and turn around and walk out in 10 minutes. It is my professional opinion.

Julia McMichael: Yeah.

Rob Oliver: So yeah, I mean, that’s just, it’s so much pressure. And yeah, I’m assuming that when they do that, there’s also pressure that you’re only handling one issue per visit.

Julia McMichael: Right.

Rob Oliver: And so people who are coming in with multiple concerns are having to come back multiple times because they’re not able to be handled in one session. Do you know, and maybe this is an unfair question to ask. Do you know if there is a mechanism built into a system like that to say somebody like me is coming in where I have some high end needs and are you able to book a double session or are you like, how does that work?

Julia McMichael: So yes, there’s definitely that option. With the six patients an hour, I did see a lot of providers say, no, we’re not doing that. Four was the highest they would go. And then, you know, there are circumstances where if you know the patient has a lot of comorbidities and there’s a lot of different issues going on, you can flag the chart. So that any time a patient tries to schedule, you know, this person needs at least 30 minutes. And then there are appointments like your wellness physical takes more time because there’s more things to fill out or a pre-op appointment. Those are also gonna be usually a 30 minute appointment because there’s more things that have to be done. But yes, I have seen in multiple places, even flags of someone’s coming in and their daughter always comes with them, that she’s the caregiver. And so there’s always more time, usually allotted to those kinds of appointments so that the healthcare provider can take the time to make sure everything’s getting done.

Rob Oliver: Yep. Listen, Julia, thank you so much for joining me. I appreciate you being here and I appreciate your willingness to share. I will tell you that I respect you and I appreciate your perspective on healthcare.

Julia McMichael: Thank you so much, Rob.

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.

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