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Rebekah Nesbitt: A Patient’s Perspective on Healthcare

We get a very special patient’s perspective on healthcare from Rebekah Nesbitt who also happens to be Rob Oliver’s sister. She joined the Perspectives on Healthcare Podcast with Rob Oliver from San Antonio Texas. She is a member of Generation X. Her interview is #18 in the patient’s perspective interview Marathon.

Here is the transcript of Rebekah Nesbitt: A Patient’s Perspective on Healthcare:

Rob Oliver: Thank you and welcome to another edition of Perspectives on Healthcare. Today is another patient interview. It’s with Rebekah Oliver Nesbitt. It is a special interview because she is my sister and I am excited to share her thoughts with you. She joins us from San Antonio, Texas. And without any further ado, here is my interview with my sister, Rebekah Nesbitt. It is number 18 in the series. Enjoy.


Rob Oliver: Well, if you look who has joined me now, please let everyone know what your name is.

Rebekah Nesbitt I’m Rebekah Oliver Nesbitt.

Rob Oliver: And where do you live, Rebekah?

Rebekah Nesbitt: I’m in San Antonio, Texas, speaking to you from there. And I think the most important thing for everybody to know up front is that I happened to have a brother that’s your keynote speaker that you do.

Rob Oliver: I am proud to be your older brother and so delighted that you were willing and able to join me for this podcast. It’s been a fantastic experience. This doesn’t mean anything to most other people on here, but one of the witnesses for my podcast right now is Mary Fran Smith. So you better wave hello to her.

Rebekah Nesbitt Oh, hello, Mary Fran Smith.

Rob Oliver: There you go.

Rebekah Nesbitt: So nice.

Rob Oliver: Wonderful. So let’s do this. We’ve dispensed with the niceties and we’re now going jumping into the heart of what is happening. So tell me briefly a little bit about yourself and about your experiences in the healthcare system.

Rebekah Nesbitt: So, I’m a mom of three. I’m a wife, very thankful to be happily married. And as far as health care goes in our home, we had a mom with a lot of health challenges as we grew up. You had some health challenges? I had my own health challenges. And then especially when your injury happened, that was a big push forward in health care for me. All of that led me to want to study, to be a nurse. And I got my BSN from Villanova University for Villanova because of actually your injury and the connections that we have. I worked at McGee Rehab Hospital in physical rehab, brain injury, spinal cord injury. At that time, they called the other unit a mixed disabilities unit. I don’t know what they would say now, orthopedic, Guillain-Barré like that. And then, of course, your own health issues as you go along. Some chronic back issues. Kids are born. Fast forward to the more fun things. We have a daughter who’s an occupational therapy assistant, a son who’s in nursing school, and our youngest son is in high school, and he’s in a school that actually is for students who hope to pursue a medical career. So, kind of lots of experience on both sides. My husband and I dedicate our full time, as you well know, to sharing the Bible with others, to missions work that took us to Mexico for 16 years ago, for about 14 years. We’ve been two years now in San Antonio. And we learned a lot as well there from time the kids had to go to the Er from different health crisis we had watching and going through with people that we love their health situations and understanding a little bit more about healthcare in a third world country. That’s a big part of our experience as well.

Rob Oliver: Yes. Can you talk a little bit about the Mexican healthcare system?

Rebekah Nesbitt: Yeah. So, as you well know, wouldn’t be any kind of expert just from our own personal experiences. I can speak from that, actually. This kind of jumps ahead to maybe something that we’ll touch on later. But I think there’s some real challenges there as far as healthcare being equally available to all. There’s private pay insurance and you can get very good healthcare, well trained professionals. Many people fall into the category of a government based insurance, which is a reasonable care. Many times it’s good, it’s a little hit or miss, but then there’s a lot of people that are left to they would have called it the regional hospital. And it’s where you go if you don’t have anywhere else to go. And I think sometimes people fear more going in there and not coming out than anything else. Very challenging for people.

Rob Oliver: So is the regional hospital, would that be like a community hospital here where it’s a little bit lower level of care? Talk to me about what that regional hospital means, please.

Rebekah Nesbitt: I want to be very respectful because I’m sure there’s a lot of people there that have studied and take their job to heart. They just don’t have the resources available in Mexican, in the hospital, in Mexico in general. One thing that’s very different is that you don’t have always the adequate nursing staff. So you must always have in any hospital, one family member present with the patient at all times, 24 hours a day. So it’s a real challenge for family dynamics because people are in a situation where now all of a sudden, they’re covering days and days of 24 hours in the hospital. And they do a lot of the basic nursing care for their family members. And in the regional hospital particularly, so the family does a lot of the care. Maybe at a place like that, if there may not be medicine available that your family member needs. So the family is trying to pull their resources to go and get that medicine for the person. Many times there’s very limited visiting hours. So people are waiting outside in the hot sun for maybe the hour that they’re allowed to go inside to visit their family members. So a very challenging place and scary for people.

Rob Oliver: Okay. Pardon my ignorance on this, but what is the payer situation with the healthcare system in Mexico? Is their insurance, is it private? Have it pay? Does the bill fall on you? How does that work?

Rebekah Nesbitt: So from my own understanding, just from having lived there and having chatted with people, my understanding is that there’s essentially the three it breaks down into three categories. The first category are those that would have a private pay insurance or would be just paying out of their own pocket, which is something that we would have done because we didn’t have any kind of insurance there to speak of. So you can either pay for your own care, or you may have a third party payer. That’s one group. Those are good hospitals, private hospitals. The upper tier, you might say, of hospitals. The middle sections are those that have government insurance. It’s called the Segura social, and it’s government insurance through their work. And that’s something that people work. It’s a very big perk in a job if you can get that, because you basically have access to your medications and to all of your doctor’s visits. That I’m not 100% sure, but I believe they’re if not totally covered, they’re mostly covered by the government. Now, mind you, that has you waiting in lines, and they say in Spanish, doing welfare, which means going around and around, waiting in lines, waiting for an appointment, waiting, waiting, waiting for everything, and having to go for paperwork and two and three visits to get anything done. So that’s the middle group. The third group would be those that don’t have access to either of the other two, and they would be the ones they might be in the regional hospital or for a lot of their healthcare needs. They’re talking to their neighbor. And a lot of medications in Mexico do not require a prescription. Only recently do antibiotics require a prescription. But other than those blood pressure medications, a lot of pain meds. Most things you can get over the counter. So people, oh, I think I have high blood pressure. My neighbor said that she took this for her blood pressure, so I’m going to try to take that. So you have a lot of very scary things happening because people are just doing they don’t have access to the care, so they’re just doing what their neighbor said or their brother said worked for them. And that’s when you’re there as a healthcare worker and you’re talking to people, you’re thinking, oh, my!

Rob Oliver: Yeah.

Rebekah Nesbitt: You worry for their good.

Rob Oliver: Okay, so I have to tell you a quick story. Yesterday, I went and I got my haircut so that I would look all duded up here.

Rebekah Nesbitt: For sure. You do look really good.

Rob Oliver: Thank you so much. You’re not even slightly biased. I just want to see how you look in 24 hours. Yeah, I’m afraid I don’t want you to see how I look in 24 hours. But my barber, he had developed a sore on his leg that was pretty bad. And so he was going to the doctor to get help with that, and he went home from the doctor, and he was talking to his son in law, and his son in law was telling him, like, you need to clean it out, and you need to get some hydrogen peroxide and giving us some advice. And he was doing it. And it turns out that what he was doing was actually harmful to the wound and making it worse. And so when he went back to he went back to the doctor, the doctors like, what are you doing? What’s going on? And basically said, who told you to do this? And he said, well, my son in law did. He said, well, what does your son in law do for a living? He says, well, he’s a carpenter. Okay, listen, if you want to get a doctor to build your house, then by all means, take medical advice from a carpenter. Does that sound like kind of what was going on down in Mexico?

Rebekah Nesbitt: Yes. It’s by necessity, because people simply cannot afford to go, and when they don’t feel well, it just self diagnose and many times self medicate. And so there’s a lot of education needs as well for people.

Rob Oliver: Okay, sure. Have you met any healthcare heroes along the way, people that you want to salute for doing it right?

Rebekah Nesbitt: Absolutely. There’s a lot of people that I could even for example, our pediatrician in Mexico was very good with our kids. Many people I worked with, I worked also in a cardiology office for a time. I actually meant to mention that when I was in college, which gave me some exposure on the insurance side of things, which is such a big deal in health care as well. But the people that immediately sprung to mind with that question are two people that I remember very well from actually the time of your injury after transports and ICU time, and all that was happening within the dynamics of our family in such a time of upheaval and so much concern and worry for you. And you were discharged from Thomas Jefferson. It was a step down unit, as I recall, and you were transported to McGee Rehab Hospital. We arrived at McGee Rehab Hospital, and our first nurse, Kim Riley, was your day nurse, and our evening nurse, Elise Der Dornick, both of them immediately began putting tools in our hands for your care and to begin to give you back so much of what had been lost in the previous days. They stood out for me. It was such a watershed for me as your sister, it felt like a turning point in your recovery because things just started to look like we were going to be able to start to put the future back together again. And I think it was their knowledge base, their care, but ultimately their desire for your knowledge and independence. That really set them apart.

Rob Oliver: OK, you know what’s really funny is I was thinking about this question and if somebody said to me, who is your healthcare hero? Kim Riley is number one on my list and Elise is number two because Kim was fun and she would come in and there were these gel pads that you would use for people that needed wound care, all right? And so one day she’s treating somebody and there’s four of us in the room, and she says, hey, guys, look. And she takes one of the gel pads, peels off the cover for it and throws it straight up in the air and it sticks to the acoustic ceiling tile. And it was just like we all laughed about it and it was funny. And then the problem was that it stuck there and it was there for multiple months. But she showed me that you can have fun given through the rehab process. And I would be absolutely sorely remiss if I also didn’t acknowledge Mary Fran Smith.

Rebekah Nesbitt: Yes.

Rob Oliver: Because I was 16 years old, was in the hospital, was feeling very sick. And she is one of the people that came to my defense and showed that human compassion that says, here’s a kid who’s sick and he needs to feel better, he needs to do better, he needs to be able to get back to doing what he loves and to doing what he needs. And it’s for that reason that I maintain a relationship with her to this day, because of that support. And to me, that’s somebody who was definitely doing it right. I’m sorry. And I don’t say that just because she’s witnessing right now. I say that because I mean it from the bottom of my heart.

Rebekah Nesbitt: Yes. And I think the very fact that you could tell me this many years later, Mary Fran is here, and I know exactly who you mean, and I remember as well her care and the fact that she would show up today only supports what you’re saying is being true.

Rob Oliver: Yeah, she’s the bomb.

Rebekah Nesbitt: Shout out to you, Mary Fran.

Rob Oliver: All right, tell me, what does quality health care mean to you?

Rebekah Nesbitt: I think you could probably write a thesis on that. Right? I say you because I wouldn’t be capable of such things. There’s a lot of things you could say. I think my thoughts on that are rooted maybe in more of the international aspect of our health care background. And I think just the accessibility of care to people that, as I was mentioning before, so many people on their own with their care, guiding their own care because they simply do not have the accessibility to it, that’s a greatly limiting factor, the affordability of it, it’s tied in with the same thing. Also, our personal experience, we’re considered to be self employed. So we’ve always had a challenge to have good health care coverage and so we find ourselves many times skipping out on certain things because they’re not covered. And so we simply don’t do those things. And at times we’re in arres with some of our follow up necessities for the same reason. So that’s part of that package, I think, just simply simple competency. We’ve heard many times of recommendations that are given to patients that you’re thinking that’s not going to be the thing that helps you. So just well trained professionals, those are all very fundamental we would consider, I think, in a country like the United States. But those are not things that we can take for granted because we’re among a very blessed people that have access to that kind of competent care.

Rob Oliver: Yeah, just that idea of having to make choices about your health based on finances and there are people who talk about this, having to choose between eating ramen all week and getting your medication to choosing to eat a little bit better and not be able to afford your medication. Those are very difficult decisions that we’re asking people to make. So very challenging and difficult. So what do you wish your medical providers understood about you?

Rebekah Nesbitt: Well. I would say that speaking to the point that I just brought up previously about our personal health care needs and some of the insurance complications that we’ve run into. I think it’s so helpful when you have a chance to talk to your health care provider and explain your situation and really them have a chance to go over with you what is really necessary out of your health care plan and what alternative means there might be for you to do things. Maybe even public clinics that are available for. Let’s say. A mammogram during Breast Cancer Awareness Month. Making you aware of those kinds of things or making you aware of generic prescriptions that might be able to help you. I can actually give you an example of someone that I think did a really good job with that I have a very simple skin condition, Rosacea, that I need to take medication for and there’s a new treatment for it that uses a particular antibiotic at a 40 milligram doses dosage, I’m sorry, every day to help with the inflammation of the skin. And it’s a very, very expensive treatment procedure. And I sent to the dermatologist, I won’t be able to keep that up. It’s not really important for me. I don’t see a lot of value in starting that because if it’s successful, it doesn’t matter, I can’t keep doing that. And he said, well, what we can do, that’s patented, so there’s nothing else like that. But what we can do is do a generic substitute in a milligram amount that you can break and it will be essentially the same thing for you. So instead of paying for the patented amount, we’re getting close to that, but in a generic way. And that’s something that you really appreciate because that’s something I can do now and it has been a great help for my Rosacea.

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

Rebekah Nesbitt: I think listening. That’s in so many things in life, but really listening to the patient, understanding where they are and something as simple as the example that I gave, understanding what they would like to do, what their health goals are, starting with what their symptoms are, what their needs are, what they’re coming to you for. I think listening. And that extra time to understand where people are and how to tailor your care specifically to them. To me, those are very meaningful in giving quality health care and addressing the genuine needs of the patient.

Rob Oliver: Rebekah, thank you so much for being with me today. Thank you so much for your support. Hey, I love you. Love to the family and John, Mariah, David and Jacob, you all get a shout out on the podcast.

Rebekah Nesbitt: Thank you. I love you too, and I love your family and thanks for trusting me to have me on. You never know what a sister might say, and I hope you do great the rest of your time. Thanks for everything.

Rob Oliver: Yes, I respect your thoughts and your opinions on healthcare. Talk to you later.

Rebekah Nesbitt Thank you. Bye bye.

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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.

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