Interview with Dr. Julia Hallisy | Sound Authors Radio
November 3, 2008
Dr. Kent: Welcome back to Sound Authors. It’s Friday the 13th of June. It’s a beautiful day out here in New York; its cooled off a little bit there is suffering a little bit and it makes you think at this time of the summer back to in the New York area many times when there’s been heat stroke and things like that and while we’re thinking about the complex medical world, my next guest on the show has a book called The Empowered Patient: Hundreds of Life Saving Facts, Action Steps and Strategies You Need To Know by Dr. Julia Hallisy. Welcome to the show.
Dr. Hallisy: Thank you.
Dr. Kent: There’s so many things that we could talk about honestly from you know, it certainly feels like any time you go to the doctors office you’re in for some discomfort. What was your impetus to write this book?
Dr. Hallisy: After ten years of interacting with the system because of my daughters cancer diagnosis, we had this information and experience and I felt the responsibility to share it with others so they wouldn’t have to learn the hard way like we had. It’s a book I wish I had when my daughter was ill because it would’ve spared all of us a lot of anxiety and a great deal of suffering.
Dr. Kent: Small things like you know this infection that’s been spreading around the country. Its terrifying, especially elderly folks that end up in the hospital and young infants. What do we do about things like infections that we don’t seem to have any control over?
Dr. Hallisy: Well you know I think the reality is that patients have a lot more control on those issues than they even know about. I devote an entire chapter in my book to infection control and prevention because it is so important. Even though we all know how important it is this day for health care washes to do something as basic as washing their hands and that hospital infections can be life threatening, its difficult for patients to discuss something like hand washing. And it’s especially difficult to broach the subject after somebody has neglected to wash their hands.
So I tell people that they need to be proactive meaning that they need to state their expectations up front, right from the beginning. So before a provider even touches you, you simply state something to the effect of, “I know infections are a big problem in healthcare and I won’t feel comfortable unless I ask everyone to wash their hands and wear gloves if needed.” And no one wants to make patients feel uncomfortable. And their response will be of course I’m happy to, or of course we do that with all of our patients.
The patients don’t want to be in the position of being the hand washing police so I tell them don’t wait for somebody to breach protocol and then pounce on them. Tell your provider that you’re trying to assume more responsibility as a patient and that you’re trying to keep yourself safe from infection. No ones going to argue or feel offended by that logic, especially if you’re polite about it.
Dr. Kent: Can you explain to the listeners and to me what exactly happens in the worst case scenario? You’re thinking oh gosh, I’d really like to ask them to wash their hands or wear gloves and you don’t do that and lets say the worst happens. What could happen?
Dr. Hallisy: Hospital inquired infections; there is 1.7 million hospital acquired infections a year and that number comes from the center of disease control, and 99,000 of them are fatal. So you have a lot on the line when it comes to this and if people realize that it isn’t just oh, you know, am I going to get a rash on my skin or am I going to have my IV have to be started over or potentially talking about your life.
So if people realize that, I don’t think they would feel at all uncomfortable about saying this is really important, I can’t overlook this. I mean there’s lots of things patients can do to help prevent infections in hospitals. But first and foremost all the experts if we remind the staff to wash their hands and wear gloves is number one. By far it’s the most important and I even advise patients to work on keeping their own hands clean because we know that hands carry a lot of germs.
So patients can seek an alcohol based sanitizer next to their bed, I tell them to keep Kleenex so if they have to blow their nose they have Kleenex right at their disposal. Anything they can to do to also keep their own hands clean is important.
Dr. Kent: In your book is about kind of two things. It’s about the patient and the provider and what could the providers do better? I know that’s not really the goal of you’re book, but where are the providers lacking? Where do they make their mistakes?
Dr. Hallisy: Basic things like washing hands and wearing gloves I think that a lot of times understaffing is an issue and plays a role in that. People are rushed, maybe they’re understaffed so they’re running literally from room to room and it’s easy to overlook something basic like washing hands or wearing gloves. Providers need to be more responsible about prescribing antibiotics because the overuse of antibiotics is what has gotten us into this situation of creating resistant organisms like MRSA.
So they have to be bold to say to a patient you really don’t need antibiotics for this instead of taking the quick way out and write somebody a prescription and think well this probably isn’t going to work anyway or they don’t need it but they’re insisting on it so I’ll just give it to them. I think that the American Medical Association recommends that doctors wipe the flat end of the stethoscope with alcohol before it touches each patient because we know that flat end of the stethoscope is contaminated with all kinds of bacteria because its been tested to prove that.
I think another big part is try to engage the patient more to not say its only our responsibility and were kind of overworked and pushed to the limit but to engage patients to expect them to take a little more responsibility in their care and to ask patients to speak out about their allergies or medications they’ve taken in the past and to expect patients to keep their own hands clean and things like that. I think that would make a big difference.
Dr. Kent: Talk a little bit about your background and I guess also your daughter. How you got into this and why it’s such a passion for you.
Dr. Hallisy: Well my daughter was diagnosed at five months of age with bilateral retinal glaucoma, which is malignant tumors in the retinas of her eyes and that started an immersion in the system that was really non-stop for her entire life, which was ten years. We had chemotherapy, radiation, surgery, she had a hospital acquired infection and we ended up in the intensive care unit for seven weeks on life support.
She had an above the amputation there was really never a span of more than a few months that we weren’t involved in the system and that’s the different perspective than just a single hospitalization. I mean we really felt like we were totally immersed in that system. And being a healthcare professional, I’m a practicing general dentist, I could understand the terminology, I knew what people were talking about. I did training infection control, antibiotic use, and form consent issues so I could really assess and understand what was going on. And I think most important; I had the most vital thing in my life on the line, my child.
I had so much to lose and she was helpless to take care of herself. It was really on me and my husband to rise to the occasion and to be her advocate. So we went to all of these experiences, we learned a tremendous amount and then I started making notes and kind of jotting things down, just really to pass the time. My daughter noticed one day and asked me what I was doing and I said I was writing down all of the things that we had learned about being in the hospital, how to stay safe, where the risks were and we kind of started talking.
We both agreed that it should be a book; it would be a good book for people to have. So it came right out of literally the bedside of serving, writing things down, and then we decided we wanted to share that information with other people.
Dr. Kent: All of us, all of our families, we have people coming in and out of the hospital at all times. That’s what happens in families. Give us a tip of what should we be worried about besides of course to see whether the doctor has wiped off the stethoscope, saying would it be okay if you were to wash your hands. What else are we looking for?
Dr. Hallisy: The big ticket items, the things where there’s a lot of problems are for example something as simple as urinary catheters. Most hospital acquired infections come from catheters. Certainly the patient is in a position to say if one is ordered for them, “Do I really need it? Is there absolutely no other way?” Or, if one is used to ask probably on a daily basis, does this need to be removed today? Are we at the point where we can take it out? Because the longer it’s in, the greater your risk.
Now a lot of hospitals are having people wash their body presurgically with a chlorhexadine containing body soap. So that’s something to ask about. Should I be doing that? Can you prescribe that for me? I think that we tell people don’t shave the area to be operated on a couple days before surgery because you can put little tiny cuts in your skin that can be a portal to infection. Things like people don’t realize that new federal law says that people can add their own notes to medical records.
I advise people in my book to read their medical records after being written or to get somebody their medical power of attorney to be able to be watched for them. You gain a lot of information by reading what’s going on. What you think is going on may not be what’s actually happening when you read the medical records. If there is a disagreement, if the patient isn’t making the progress they should and they feel that maybe the hospital or doctor isn’t communicating well or listening to them, they can write their own notes, their own account, their own opinions and experiences, date and sign it, and ask for it to be entered into the medical record, which is really the only official document of your hospitalization.
So there’s actually lots and lots of areas that patients can intervene in the system and really make a difference. They can talk about their allergies. I tell people don’t just assume that everybody is going to remember every single time that you’re allergic to something. But be prepared to speak up if somebody comes in and they’re going to give you something and they’re going to put tape on your arm that your allergic to, you’re going to have to be prepared to be proactive about that and remind people of things.
Dr. Kent: This has been a real pleasure speaking to Dr. Julia Hallisy. Her website is theempoweredpatient.com. The book is called The Empowered Patient: Hundreds of Life Saving Facts, Action Steps and Strategies You Need to Know. Thank you so much for being on the show.
Dr. Hallisy: Thank you.
Dr. Kent: My next guest is going to be speaking about his novel Tremolo, Cry of the Loon story. A Gus Legard Mystery. His name is Aaron Lazar. Come on back for that.
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