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Rob Oliver: A Patient’s Perspective on Healthcare

As interviewer and interviewee, Rob Oliver shares a patient’s perspective on healthcare on this unique episode of the Perspectives on Healthcare Podcast. A member of Generation X, Rob is a keynote speaker based in Pittsburgh, Pennsylvania. Additionally, he has an extensive medical history with multiple injuries and illnesses including a spinal cord injury at age 21. Following that injury, he has been dealing with a variety of medical professionals.

Here are 3 things that stood out as Rob Oliver shared a patient’s perspective on healthcare:

· Quality healthcare means that the patient is at the center of the treatment plan
· It is important to look at the person as a whole and to consider function instead of diagnosis
· It is much easier to recognize poor healthcare than it is to give an example of quality healthcare

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Here is the transcript of Rob Oliver: A Patient’s Perspective on Healthcare

Rob Oliver: Thank you. And I appreciate you being with me. Today is kind of a unique day and the perspective that you’re going to get today, if you remember a couple of episodes ago, I apologized because I told you that as I was opening the show so often, I would say, My perspective today comes from and then I would tell you who it was coming from. Well, today, actually, you are going to get my perspective on health care. So this is going to be a little bit different as I’m going to be both the interviewer and the interviewee I will be sharing with you a patient’s perspective on health care, and I hope it’s something that is going to be enlightening for you as well as give you something to think about. So we’ll jump right into it.

Question: First question is tell me about yourself and your role in health care.

Rob Oliver: I’m going to start from the beginning. And those of you that know me, I hope that you will just indulge me for sharing my story. For those that may not know, my story kind of goes back to when I was 21 years old, I acquired a spinal cord injury from a body surfing accident. I was riding a wave in towards the shore, and instead of it carrying me forward, it pushed me down. I hit my head on the bottom and I broke my neck at the C five six level. It is a complete injury, so I’m paralyzed from the chest down with limited use of my arms and hands. Although my story didn’t actually start there. My story started many, many years before that, when I was a kid, I was not necessarily an accident waiting to happen. I was an accident in progress. It seemed like no matter what I was doing, no matter where I was, I was getting hurt somehow that involved having a number of concussions, several not broken limbs, but several sprains fractures, the whole kind of thing. And in addition, there were some odd experiences of getting sick in there. So when I was in first grade, I ended up coming down with Scarlet fever, which I have no idea how that happened, but it did. Growing up, probably the time that I was eight or nine years old. I was experiencing a lot of muscle weakness, and I was at that point misdiagnosed as having muscular dystrophy. And Thankfully, I grew out of that. When I was a junior in high school, I developed irritable bowel syndrome, and I had a really difficult time. I had my appendix out around Thanksgiving, and then I never got back to school until the New Year and when I did get back to school, I was having side effects that were terrible. And so I would go to school for a couple of days, miss several days. It was rough. But I tell you all of that, to tell you that I have been in the hospital more often than I would like. I’ve spent more time with doctors, nurses and therapists than I would like. But I have definitely come to an understanding of what I expect and what I hope that others can benefit from hearing about my perspective on health care and really, what I have done with that is not only do I have this podcast to talk about perspectives on health care and bringing in other professionals to share what they’re doing. I became a trainer for medical professionals starting back in 1999 and became a keynote speaker, talking about the patient’s perspective on quality health care and really talking about patient and family centered care and really building the case for medical professionals to remember where the whole concept of health care came from and how it originated and what it’s all about. And it’s ultimately all about the patient. So that’s kind of the brief thumbnail sketch of my history as a patient as well as where I am today as a trainer and keynote speaker about quality health care, which leads into the next question.

Question: What does quality health care mean to you?

Rob Oliver: And to me, it’s very simple. The patient has to be at the center of health care. There was an Advertisement here in Pittsburgh. I think it was by UPMC, the University of Pittsburgh Medical Center who talked about how Mrs. Jones is not the hip replacement in room 51, 50, bed B, but she is a grandmother. She is a gardener. She is involved in her community, and it talked about all of the reasons why it was important for her to have a hip replacement. So she was having a hip replacement so that she could go out and get to Church so that she could go for a walk with her grandchildren and so that she could grow her flowers and her vegetables in her garden because those were all the things that were important to her, and it was really powerful, I think, to show how this is not about the diagnosis, it’s about the function and it’s about the person as well. So I think those two things are the key to me. One is it’s got to be looking at the person as a whole and understanding that the reason that they’re in for treatment is to be able to get back to doing the things that they want to do and to do the things that are important to them. And that’s why the patient’s got to be at the center. And Additionally, to move from the concept of diagnosis and move to the concept of function. So I don’t need a power wheelchair because I’m a quadriplegic. There are many different types of quadriplegic. Not all of them need power, wheelchairs. I need mine because of the functional limitations that I have, and those are unique to me as an individual. So let’s look at function rather than diagnosis.

Question: Can you give me an example of quality health care?

Rob Oliver: This one kind of makes me laugh because in doing the show, we’ve had enough episodes that every time I ask this question, folks very quickly can give me an example of what bad health care looks like. And trust me, I have had my fair share of bad experiences with health care. I remember when I was in rehab following my spinal cord injury. They tried out a new medication with me. It did not sit well with me, and it made me feel nauseous. And I had a nurse who was from South Philadelphia, and she was as stereotypical Philadelphia as you can be. She had attitude and she was maybe 5ft tall, but inside she was pretty sure that she was shakylonial. She was just dripping with a HUD spa and charisma and toughness. And I told her, Listen, I feel nauseous, and I’m concerned that I’m going to lose my medication. And she stood up to the full height of her five foot nothingness and looked at me and told me, you can’t feel your stomach. My response was, you know what? Now that you’ve told me that I feel so much better. And however, I feel like there was justice that came back because it wasn’t too awful long later that I indeed actually did lose my medication. And she had to be the one to come in and clean up everything. I tried to be gracious about it and didn’t say anything as far as like, hey, I told you that I was sick, but it was that example where I told her what was wrong. And she told me that she knew better than I did about what I could feel, what I couldn’t feel and what I was going through. That is my example of poor health care. My example of quality health care comes when I was 16 years old and I was in the hospital following that appendectomy when I was dealing with irritable bowel syndrome. And there was a lot of questions going around this stuff. What actually was happening with me was this all psychosomatic, what was the situation? And there was a nurse there. Her name was Mary Fran, and she listened to me and she stuck up for me basically to say this, like, let’s start with the fact that this is a kid who doesn’t feel good. He is sick. And let’s start there and let’s help him based on that and everything else is secondary. And so Interestingly enough, she’s someone that I have maintained a relationship with to this day. And that’s 40, some odd years later that she believed in me. She listened to me for what I was saying and was very comfortable meeting me where I was and that, to me, is quality health care. It’s somebody who is willing to listen to the patient and to acknowledge that this is where they are coming from. This is what they are experiencing and how do we treat them within the framework of what they’re going through? And to me, that is what quality health care is all about. It’s about listening. It’s about meeting people where they are, and it’s making sure that the patient is the one who is really giving the information that steers the plan of treatment.

Question: What do I wish people understood about my role in health care?

Rob Oliver: So here’s what I wish. And I’m going at this for more. From a patient advocacy perspective, there are a lot of people who look at me in a wheelchair and make a lot of assumptions about me. Most of those are not medical professionals, thankfully. But people assume that I am deaf or that I have a cognitive impairment or whatever the situation is. A lot of people make assumptions about me. And I will say that while the medical professionals don’t make those assumptions about me, they also make an assumption that I am not an expert in my care, and that is something that I have worked very hard on. One of the presentations that I do for medical professionals is called Robology 101, and the point of that is that I am an expert in me. I’m an expert in Rob, the study of Rob. I’ve got an advanced degree in Rob Ally. Okay. And I don’t want you to get an advanced degree in Robology, but I’ve got my PhD in that I’ve lived this for the past almost 50 years, and I know where I’m coming from because I’ve done the research about my injury, about my experiences, about all of the peripherals that go on with me. And so what I want people to understand about my place as a patient is that I am an informed advocate for myself, and that as a result of that, there needs to be a willingness to listen to me and to respect that. What we’re doing is we are forming a partnership together to come up with a plan of treatment that works for both the patient and the professional, because if it’s something that only works for the patient and is not the best plan of treatment according to the professional, then the patient is going to miss out on that. But if the professional comes up with a plan of treatment that neglects to take in the lifestyle, the experiences, the background of the patient, then the likelihood of them adhering to that plan of care is much smaller. And so it’s very important to come up with a plan of care that is mutually agreeable. And that is something that both parties can live with. And in that way, it’s got to be a partnership so what do I wish people understood? I wish medical professionals were much more willing to form a partnership with patients in order to come up with the best plan of care that works for both parties.

Question: What excites you about the future of health care?

Rob Oliver: There’s a little bit of this. I’m excited about technology. Okay? I’m a self professed nerd. I love electronics. I love all of the smart gadgets. Having the Alexa in our house is fantastic, and I’m able to do all the control, all of this stuff and all of that technology is a really, really cool thing. And I think telehealth is amazing, especially for people with disabilities, for whom transportation is a major concern. So being able to receive treatment in your home, to be able to talk to the doctor from your home using technology is phenomenal. There is a concern on my part, though, that in doing that, our people with disabilities going to end up being more socially isolated, where they’re not actually getting out of the house. Sometimes a doctor’s appointment may be one of the few social experiences that someone with a disability has, so to be able to have them get out of the house and go into the community. Really? To me, community integration is what we need for people with disabilities for everybody to have a place in the community. And that is regardless of race, age, disability, Creed, whatever it is, everybody should have a place in our community and we should be welcoming everyone. That being said, I also am concerned that sometimes the telehealth visits, they aren’t as in depth where you’re not getting a blood pressure, you’re not getting blood gas. There’s a lot of different things that you’re not able to get with that. I am excited about the future of health care, though, and how those pieces can be actually taken care of in the home where someone can get a pulse Ox in their home or a blood pressure cuff or whatever it is so that they’re receiving a high level of care, even if it is in their home. And to me, I think that telehealth is a way actually to keep people healthier and safer. And here’s why when people have a bad infection, where do they go? They go to the hospital. So all of the worst germs in the world exist in the hospital. And so it is something that when you go to the hospital, you are much more likely to pick up one of those germs than you are just going out and going to a local restaurant. Or what have you those nasty germs exist in the hospital. And so in that way, by not bringing people into that setting, you actually are giving them treatment in a safer place.

Question: Lastly, what is one thing medical professionals can start doing today to improve the quality of healthcare?

Rob Oliver: To me, this one is real simple. I want people to remember why they got into the medical field in the first place. That’s all I ask. Why are you doing this? Sometimes it’s easy to get jaded. Sometimes it’s easy to get so caught up in the minutiae of paperwork and insurance and just all of the other stuff that goes on. And hopefully you got into this profession because you wanted to help people. It may have been appealing because it’s a field where you can make some money. But at the end of the day, it’s really about helping people. And to me, remember your why remember what brought you to this and remember that the patient is ultimately at the center of all this care. And without patients, really, health care doesn’t exist. They are the sole reason why this profession is there in the first place. And so just that simple reminder, why did you get into this and that the patients are ultimately why you exist.

Rob Oliver: I appreciate you being with me today. I hope that you have learned a little bit from my perspective on health care. And if you enjoy the show, I would love to get a review on iTunes from you. Share it with your colleagues and anyone else that might listen. Thank you for listening to my perspective on healthcare.

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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