A More Equitable Future: The Role of Caregivers in Healthcare Disparities

100:00:00,480 --> 00:00:02,404Speaker 1: Welcome to the Healthy, Wealthy and Wise 200:00:02,524 --> 00:00:08,064podcast with Dr William Chokta, MDJD. Our mission is to empower 300:00:08,125 --> 00:00:11,897you with the knowledge and the tools you need to thrive in all 400:00:12,099 --> 00:00:16,184aspects of your life. Join us now as we discuss everything 500:00:16,285 --> 00:00:19,823from nutrition and exercise to money management and personal 600:00:19,862 --> 00:00:24,733growth. Dr Chokta will provide insightful advice on how to 700:00:24,774 --> 00:00:28,064improve your physical and financial health, as well as 800:00:28,103 --> 00:00:31,460your emotional and mental well-being. Whether you're 900:00:31,481 --> 00:00:35,930looking to boost your energy levels, unlock financial freedom1000:00:35,930 --> 00:00:40,207or cultivate a more positive mindset, we've got you covered. 1100:00:41,799 --> 00:00:45,901Get ready to become the best version of yourself? So let's 1200:00:45,941 --> 00:00:50,468get started. Here's Dr William Chokta, MDJD. 1300:00:51,289 --> 00:00:55,107Speaker 2: Good morning, welcometo the Healthy, wealthy and 1400:00:55,167 --> 00:00:58,886Wise podcast. I'm Dr William Chokta and I will be your 1500:00:58,945 --> 00:01:03,923facilitator for this program. We're delighted to have you, and1600:01:03,923 --> 00:01:08,521today we're going to talk abouthealth care disparities and 1700:01:08,600 --> 00:01:13,308give you some ideas and some suggestions about how we can 1800:01:13,909 --> 00:01:18,543mitigate health care disparitiesand provide quality healthcare 1900:01:18,603 --> 00:01:23,885for patients that we deal with. As always, i like to start off 2000:01:23,926 --> 00:01:27,359with my beliefs. I believe that life is about being of service 2100:01:27,501 --> 00:01:32,465to others. I believe knowledge is power. I believe leaders can 2200:01:32,504 --> 00:01:35,504change the world. For our discussion, we're going to talk 2300:01:35,543 --> 00:01:39,379about the definition of healthcare disparities. We will 2400:01:39,400 --> 00:01:44,109talk about the definition of healthcare equity and we'll give2500:01:44,109 --> 00:01:49,941you some specifics about how tomerge the two. This is part of 2600:01:50,022 --> 00:01:53,551our masterclass series and, as part of the series, the three 2700:01:53,631 --> 00:01:59,471areas that we address are healthcare, some legal issues, 2800:01:59,591 --> 00:02:03,641potentially, and also some financial issues, potentially. 2900:02:06,319 --> 00:02:09,310Change is one of those things that will always be with us and,3000:02:09,310 --> 00:02:14,900indeed, every day there will besome change in your life. I 3100:02:14,960 --> 00:02:22,197suggest that if you are having challenges with things that are 3200:02:22,236 --> 00:02:27,599going on, it has to do with yourrelationship with change. If 3300:02:27,620 --> 00:02:31,449you have a good relationship with change, then you are 3400:02:31,468 --> 00:02:35,108probably happy. If you don't have a good relationship with 3500:02:35,149 --> 00:02:38,443change, then you're probably dealing with more and more 3600:02:38,502 --> 00:02:43,967challenges. My point, very seriously, is to look at what 3700:02:44,008 --> 00:02:48,121your issues are and how you feeland to see what your 3800:02:48,161 --> 00:02:54,406relationship is with change. Let's focus in on our primary 3900:02:54,485 --> 00:02:58,263issue today healthcare disparities. Albert Einstein 4000:02:58,383 --> 00:03:01,911once said if I had 60 minutes tosolve a problem, i would spend 4100:03:01,971 --> 00:03:07,40355 minutes defining the problem.Let's define what healthcare 4200:03:07,443 --> 00:03:13,140disparities is. What does it actually mean? Very simply, 4300:03:13,983 --> 00:03:18,733healthcare disparity means patients who are similar 4400:03:18,853 --> 00:03:23,544situated being treated differently. Let me say that 4500:03:23,604 --> 00:03:29,855again Patients who are similarlysituated being treated 4600:03:30,258 --> 00:03:34,588differently. For example, two patients come into the emergency4700:03:34,588 --> 00:03:39,466room. They're both 20 years of age, they've both been involved 4800:03:39,506 --> 00:03:43,919in automobile accidents, separate parts of the city, but 4900:03:43,959 --> 00:03:47,300they're brought to the same emergency room. Both are 5000:03:48,022 --> 00:03:56,46518-year-old men and have a fracture of the left femur, left5100:03:56,465 --> 00:04:03,391leg. Patient A is the son of a member of the board of directors5200:04:03,391 --> 00:04:08,747. Hospital has a policy that if any member of or family member 5300:04:08,907 --> 00:04:13,700of a board member comes into thehospital, they are to 5400:04:13,760 --> 00:04:18,187immediately notify the administrator on call and to 5500:04:18,247 --> 00:04:23,254make sure that the administratorgets involved with the care of 5600:04:23,274 --> 00:04:28,165that patient. Patient is placed in a private room and someone 5700:04:28,206 --> 00:04:33,954from administration will come down and welcome the patient and5800:04:33,954 --> 00:04:39,625or their family member. PatientB 18 year old young man 5900:04:40,545 --> 00:04:46,653different accident but same problem fracture of the femur is6000:04:46,653 --> 00:04:51,783brought into the same emergencyroom. He is the son of a single6100:04:51,783 --> 00:04:57,891parent. His family, his mother,does not have insurance and he 6200:04:59,932 --> 00:05:03,963is basically healthy. Otherwise.He is placed in the emergency 6300:05:04,024 --> 00:05:10,949room and individuals interview him, x-rays are done and it's 6400:05:11,009 --> 00:05:15,101taken some time for them to get the doctor in to see him. There 6500:05:15,141 --> 00:05:21,396is a particular orthopedic surgeon on call and he's been 6600:05:21,435 --> 00:05:24,062called and they're trying to getin touch with him. What's my 6700:05:24,122 --> 00:05:30,250point? My point is two almost exact type of medical problems, 6800:05:30,571 --> 00:05:33,482but the treatment is different. So what we're going to do is 6900:05:33,502 --> 00:05:37,387we're going to explore why is itthat some of the treatment is 7000:05:37,466 --> 00:05:42,353different in these situations and exactly what all that means.7100:05:42,353 --> 00:05:48,875If we look very closely, situations like this happen in 7200:05:48,915 --> 00:05:53,464hospitals all over the country. The reality is that patients are7300:05:53,464 --> 00:05:59,533not always treated exactly the same and there analyze the issue7400:05:59,533 --> 00:06:03,245of health care disparity, and this is what we're going to look7500:06:03,245 --> 00:06:08,603into today. There are a number of reasons for health care 7600:06:08,642 --> 00:06:18,213disparities. Certainly, it has to do with one's ability to pay.7700:06:18,213 --> 00:06:25,571Sometimes It may have to do with one's ability to understand7800:06:25,571 --> 00:06:32,064the environment, education, language All of these may. There7900:06:32,064 --> 00:06:36,293will be limitations, or there certainly be influences about 8000:06:36,353 --> 00:06:41,528how quality care is rendered at a time. Whose responsibility is 8100:06:41,588 --> 00:06:45,088this? I'm going to argue that this is the responsibility of 8200:06:45,108 --> 00:06:49,240the caregiver either doctors, nurses and hospital employees, 8300:06:49,661 --> 00:06:54,247and my operational definition ofcaregiver is anyone who works 8400:06:54,307 --> 00:06:59,877in a hospital that has impact ona patient. Anyone who works in 8500:06:59,937 --> 00:07:03,302a hospital is a caregiver. Whether you're in food services,8600:07:03,302 --> 00:07:06,786whether you're environmental services, whether you are 8700:07:07,567 --> 00:07:12,754provide my secretarial services or in surgery, or a nurse or a 8800:07:12,793 --> 00:07:16,345physician, it does not matter Ifyou have impact on that 8900:07:16,404 --> 00:07:21,422patient's experience. You indeedare a caregiver And you're part9000:07:21,422 --> 00:07:25,288of that team of individuals whoare responsible for providing 9100:07:25,329 --> 00:07:30,142quality care for the patient. Soone of the things that we've 9200:07:30,223 --> 00:07:35,752noticed is that, more recently, more and more patients are 9300:07:35,793 --> 00:07:44,326diverse, and one of the reasons for this is that in 2010, when 9400:07:44,346 --> 00:07:48,011the Affordable Care Act was passed, that increased the 9500:07:48,091 --> 00:07:53,300number of individuals who basically have health care. It 9600:07:53,319 --> 00:07:57,526expanded health care coverage, fortunately for large, for 9700:07:57,567 --> 00:08:01,413millions of individuals, of patients, so that they could be 9800:08:01,473 --> 00:08:05,798provided quality care and live long and thrive like all the 9900:08:05,838 --> 00:08:11,336rest of us. Along with that thathas brought in more challenges 10000:08:11,416 --> 00:08:15,764in the health care area, and it is our responsibility as 10100:08:15,805 --> 00:08:19,269healthcare providers, like myself and others, to meet those10200:08:19,269 --> 00:08:22,053challenges and provide the veryhighest quality of care 10300:08:22,574 --> 00:08:27,059possible. So there are a number of reasons for these disparities10400:08:27,059 --> 00:08:32,085, and let's say, on the patient's part, age, genetic 10500:08:32,306 --> 00:08:36,009health behavior, chronic illnesses. There may be 10600:08:36,049 --> 00:08:39,793community factors such as education, health care access, 10700:08:40,534 --> 00:08:44,863community norms, neighborhoods. There may be system factors, 10800:08:44,942 --> 00:08:49,967such as local public health services, social services, 10900:08:51,349 --> 00:08:57,596social, economic and health systems. Never the least, it is 11000:08:57,635 --> 00:09:01,740the responsibility and my judge of caregivers those of us 11100:09:01,821 --> 00:09:07,969involved with the process of caring for others to make sure 11200:09:08,548 --> 00:09:13,054that we eliminate health care disparities as much as possible.11300:09:13,054 --> 00:09:17,105So what are some of the solutions to health care 11400:09:17,125 --> 00:09:20,958disparities? First thing is thatwhenever there's a problem or 11500:09:21,460 --> 00:09:25,767circumstance that one is dealingwith, it's important to, as 11600:09:25,826 --> 00:09:30,499some say, not to bore the ocean.I am sure you, like me, have 11700:09:30,559 --> 00:09:32,884been involved with many different meetings about many 11800:09:32,923 --> 00:09:37,876different issues involved in health care. But what happens, 11900:09:37,937 --> 00:09:42,041what tends to happen sometime, is that we try to solve all the 12000:09:42,100 --> 00:09:47,527problems all at once and to the extent that many times one feels12100:09:47,527 --> 00:09:51,610overwhelmed and feel like that it's almost an impossible task. 12200:09:52,576 --> 00:09:55,187One of the things that I have learned in my 50 years of health12300:09:55,187 --> 00:09:59,480care is to do the very opposite. It's to start small and then 12400:09:59,539 --> 00:10:04,615grow and do something larger, tostart with the basics. So I 12500:10:04,635 --> 00:10:10,638would suggest number one let's not bore the ocean, let's not 12600:10:11,840 --> 00:10:17,369try to solve world peace or create world peace, etc. Etc. 12700:10:18,054 --> 00:10:21,464But let's do the things that we can do. Let's control the 12800:10:21,524 --> 00:10:24,821control of the boats, and indeedthere are things that are under12900:10:24,821 --> 00:10:29,302our control, and these are the things, in my judgment, that we 13000:10:29,341 --> 00:10:34,903should work very closely on. So let's simplify it. So how do we 13100:10:34,942 --> 00:10:38,582simplify it? First, let's start with the individuals involved. 13200:10:39,054 --> 00:10:44,065We have caregivers, like those of us who work in hospitals or 13300:10:44,085 --> 00:10:48,100provide health care services, and we have patients. We have 13400:10:48,160 --> 00:10:53,403two entities. Our goal is quality health care. Our goal is13500:10:53,403 --> 00:10:58,524quality health care. So, in effect, the caregiver patient 13600:10:59,187 --> 00:11:05,020association is a relationship. It is a relationship, whether 13700:11:05,081 --> 00:11:08,187it's a doctor patient relationship, nurse patient 13800:11:08,226 --> 00:11:11,350relationship, caregiver patient relationship. It is a 13900:11:11,410 --> 00:11:14,461relationship. And we have some understandings about 14000:11:14,522 --> 00:11:17,518relationships, right. So we're going to apply those 14100:11:17,577 --> 00:11:21,267understandings to this very, very large and seemingly complex14200:11:21,267 --> 00:11:24,341problem. So the first thing that we're going to start with 14300:11:24,601 --> 00:11:30,225is perception. Perception is reality. And let me be more 14400:11:30,326 --> 00:11:38,144specific. We know from our anatomy and our psychology and 14500:11:38,224 --> 00:11:42,570our psychiatry that what we believe affects how we think. 14600:11:43,576 --> 00:11:48,985What we think affects how we feel And how we feel affects how14700:11:48,985 --> 00:11:55,046we think about that. What we believe affects how we think. 14800:11:55,996 --> 00:12:01,327What we think affects how we feel And how we feel affects how14900:12:01,327 --> 00:12:06,943we act. If we have a belief system about a certain patient 15000:12:07,004 --> 00:12:11,471population, i guarantee you that's going to translate into 15100:12:11,652 --> 00:12:17,143our actions in dealing with thatcertain patient population, 15200:12:17,783 --> 00:12:22,119positively or negatively. So oneof the things that we can 15300:12:22,178 --> 00:12:27,335control or have some control over is our belief system, and 15400:12:27,375 --> 00:12:30,842so I would suggest, to start with, if you're starting to have15500:12:30,842 --> 00:12:34,456negative beliefs about a certain patient, you don't even 15600:12:34,475 --> 00:12:38,004know the patient, but you walk into the room and already you 15700:12:38,044 --> 00:12:41,818get an impression. And if that is, if that impression is 15800:12:42,019 --> 00:12:46,667negative, i suggest to you that you pause and take a step back 15900:12:47,668 --> 00:12:51,340and regroup, because already you're starting down a path 16000:12:51,821 --> 00:12:55,246that's probably not going to be beneficial to you and or the 16100:12:55,287 --> 00:13:01,657patient. So that's a very, very easy first step. Second thing is16200:13:01,657 --> 00:13:06,104we're dealing with systems, hospitals of very, very large 16300:13:06,144 --> 00:13:10,048systems, offices, or significantly complicated 16400:13:10,089 --> 00:13:14,059systems, and what I have learnedand what many of us have 16500:13:14,100 --> 00:13:17,986learned in quality management and quality improvement is that 16600:13:18,147 --> 00:13:22,318when problems develop or outcomes are not ideal or 16700:13:22,440 --> 00:13:27,208outcomes are not what we want them to be, nine times out of 16800:13:27,288 --> 00:13:31,649ten is the process, not the people. Let me say that again 16900:13:32,495 --> 00:13:37,267When problems develop, let's sayin a hospital, mistakes occur. 17000:13:37,654 --> 00:13:41,817Well, things don't occur the waythey're supposed to occur. Nine17100:13:41,817 --> 00:13:46,777times out of 10 is the process,not the people. I remember at 17200:13:46,797 --> 00:13:50,975my hospital as Chief Transformation Officer, i used 17300:13:50,995 --> 00:13:57,398to say when in one of the regular C-suite meetings and the17400:13:57,398 --> 00:14:00,339issue would come up where maybea nurse has given the wrong 17500:14:00,379 --> 00:14:05,442medication to a patient, oftentimes the result would be 17600:14:05,682 --> 00:14:10,784folks would be fired. I would make the plea when people make 17700:14:10,845 --> 00:14:14,940mistakes, when caregivers make mistakes, do not fire them 17800:14:15,581 --> 00:14:19,403immediately. Send them down and have a conversation with them 17900:14:19,865 --> 00:14:24,325and say tell me what was going on on your ship when XYZ 18000:14:24,424 --> 00:14:30,644happened? Why? What's my point? Nobody comes in to work planning18100:14:30,644 --> 00:14:33,755to make a mistake. As a matter of fact, that's an oxymoron. If 18200:14:33,796 --> 00:14:37,802you plan it, it's not a mistake.When a mistake occurs, it is 18300:14:37,861 --> 00:14:43,705not planned. What you will discover, as many have, is that 18400:14:43,845 --> 00:14:48,020you have a process that this nurse or doctor or healthcare 18500:14:48,061 --> 00:14:54,903giver is involved in. That creates an environment that 18600:14:54,964 --> 00:15:00,524causes them to make a mistake and not reach their 100 percent 18700:15:00,585 --> 00:15:04,839potential. What's my point? My point is look at the process, 18800:15:05,341 --> 00:15:07,499not the people. Now, certainly, you're going to look at the 18900:15:07,539 --> 00:15:12,224people to some extent and maybe one-tenth of one percent will be19000:15:12,224 --> 00:15:15,302a people problem, but I guarantee you 99 percent of the 19100:15:15,342 --> 00:15:19,941time it's going to be a process problem. The one way you will 19200:15:19,980 --> 00:15:23,538know that is that you will have a problem. You'll have a big 19300:15:23,599 --> 00:15:28,344meeting and you'll do all sorts of brute-cost analyses on those 19400:15:28,404 --> 00:15:31,582problems and then you will come up with a solution for their 19500:15:31,623 --> 00:15:35,019problem. Six to eight months later, the same problem will 19600:15:35,058 --> 00:15:39,943occur again. After you have fired Nurse John or Nurse Mary. 19700:15:40,385 --> 00:15:43,201Somebody will say but I thought we solved that problem when we 19800:15:43,261 --> 00:15:46,356let so-and-so go. Well, you didn't solve the problem. Yeah, 19900:15:46,397 --> 00:15:50,176you did fire somebody, but the problem is in the process. It is20000:15:50,176 --> 00:15:54,523not in the people. All you did was change and put somebody else20100:15:54,523 --> 00:15:58,982into that same broken process. I would encourage you that if 20200:15:59,003 --> 00:16:02,735you were having challenges with quality, with your patients, to 20300:16:02,794 --> 00:16:07,346look at your processes more thanyou're looking at your people. 20400:16:08,255 --> 00:16:13,543That's more difficult, arguably,but it is most important to 20500:16:13,602 --> 00:16:18,104solve the problem. What is the solution to health care 20600:16:18,124 --> 00:16:22,445disparities? Well, the solution,obviously, is health equity, 20700:16:23,076 --> 00:16:26,457equality and treatment for patients, for all patients, 20800:16:27,080 --> 00:16:30,779irrespective of their status in life, irrespective of what 20900:16:30,899 --> 00:16:34,937families they're from, etc. If you are a human being, you have 21000:16:35,037 --> 00:16:38,678a fundamental right to quality care. Indeed, that was one of 21100:16:38,698 --> 00:16:42,501the principles of the AffordableCare Act that was passed and 21200:16:42,562 --> 00:16:46,138signed by President Obama in 2010. You have a fundamental 21300:16:46,197 --> 00:16:52,424right to quality care. That is our responsibility as caregivers21400:16:52,424 --> 00:16:56,787. One of the reasons why this isa bigger problem now than it 21500:16:56,846 --> 00:17:04,425was 30 years ago is that, with the expansion of the Health Care21600:17:04,425 --> 00:17:09,115Act and more people coming intothe system, the complexities 21700:17:09,196 --> 00:17:13,233have significantly increased, and all the more reason for 21800:17:13,273 --> 00:17:16,652those of us in leadership positions And basically I'm 21900:17:16,672 --> 00:17:20,000talking about a caregiver now, any caregiver, as compared to a 22000:17:20,039 --> 00:17:23,497patient. It is our responsibility to solve these 22100:17:23,617 --> 00:17:28,079issues, and one of the ways to solve the issue is health equity22200:17:28,079 --> 00:17:32,498, and one of the ways to create health equity is to start with 22300:17:32,577 --> 00:17:37,316what I call the person in the mirror. Let's say I'm Dr Chokta,22400:17:37,316 --> 00:17:42,276i'm a general surgeon And I have called to the emergency 22500:17:42,336 --> 00:17:47,779room to see a patient. It is my responsibility to go into that 22600:17:48,481 --> 00:17:51,672environment with a certain attitude mentally before I even 22700:17:51,711 --> 00:17:57,538get there, and beliefs need to lead to thoughts. Thought leads 22800:17:57,557 --> 00:18:02,892to feelings and feelings lead tobehaviors. And so if I want 22900:18:02,932 --> 00:18:05,459things to come out of certain way, i need to start with a 23000:18:05,499 --> 00:18:09,498certain attitude before I even get to the emergency room to see23100:18:09,498 --> 00:18:15,798that patient. You would be amazed at how we predict outcome23200:18:15,798 --> 00:18:21,632by our belief systems and by our attitudes. And so if you're 23300:18:21,673 --> 00:18:25,208seeing a lot of negativity around you, take a look again at23400:18:25,208 --> 00:18:28,778the person in the mirror and begin to question what your 23500:18:28,837 --> 00:18:32,978beliefs are. So what have we learned? in conclusion? 23600:18:34,130 --> 00:18:38,265Healthcare disparities is a horrible situation that creates 23700:18:38,345 --> 00:18:43,416poor healthcare for a number of people. It leads to mistakes in 23800:18:43,477 --> 00:18:48,392healthcare. It leads to less than quality care. We can do 23900:18:48,432 --> 00:18:51,872better. We can do better, we should do better, and the best 24000:18:51,951 --> 00:18:54,523way to do better is to start with the person in the mirror, 24100:18:55,067 --> 00:18:59,519make sure that our beliefs are positive and are in alignment 24200:19:00,079 --> 00:19:03,538with our thoughts And our thoughts are in alignment with 24300:19:03,618 --> 00:19:06,411our feelings and that our feelings are in alignment with 24400:19:06,490 --> 00:19:11,316our behaviors. If we do that on a positive level, we're setting 24500:19:11,416 --> 00:19:16,297ourselves up to succeed, and if we succeed, our patients succeed24600:19:16,297 --> 00:19:19,458, because ultimately, we're talking about a relationship, 24700:19:20,609 --> 00:19:24,571and relationships are based on three things Mutual respect, 24800:19:25,053 --> 00:19:29,592mutual trust and good communication. And even though 24900:19:29,632 --> 00:19:33,880this is a relationship, keep in mind that we, and we, the 25000:19:33,920 --> 00:19:37,733caregiver, have the authority and the power in this 25100:19:37,814 --> 00:19:43,713relationship that the patient does not have. Consequently, we 25200:19:43,794 --> 00:19:48,395must take the lead. We have thatresponsibility to take that 25300:19:48,476 --> 00:19:53,651lead and to make sure that the patient does well and receives 25400:19:53,691 --> 00:19:58,534the very highest quality of care. One of my friends used to 25500:19:58,694 --> 00:20:02,269always mention, when we talk about healthcare quality is to 25600:20:02,410 --> 00:20:06,136use the mom test. What type of care would you want your mother 25700:20:06,156 --> 00:20:10,323to get If she were a patient whohad been in an auto accident 25800:20:10,383 --> 00:20:13,493and had a fractured femur and was rolled into the emergency 25900:20:13,595 --> 00:20:20,599room? Your approach works for you as fine, as long as you make26000:20:20,599 --> 00:20:25,016sure that your beliefs are positive and fair and honest, 26100:20:25,930 --> 00:20:30,059because that will dictate what the result is going to be in 26200:20:30,099 --> 00:20:34,530terms of your actions. That is my only conclusion. Our 26300:20:34,590 --> 00:20:38,259relationships are based on mutual respect, mutual trust and26400:20:38,259 --> 00:20:43,797good communication. I believe with my basic principles. Number26500:20:43,797 --> 00:20:48,431one God is in charge. I am a physician of faith and indeed it26600:20:48,431 --> 00:20:51,977has been my faith that has sustained me over the years and 26700:20:52,057 --> 00:20:59,616has allowed me to do the things that I wanted to do and to 26800:20:59,656 --> 00:21:04,730succeed and be helpful in a positive way. My second basic 26900:21:04,849 --> 00:21:08,823principle is I don't have any bad days. I decided many years 27000:21:08,903 --> 00:21:12,394ago that whether my day was goodor bad was completely up to me,27100:21:12,394 --> 00:21:16,848so I decided I didn't have one anymore bad days, and so now my 27200:21:16,888 --> 00:21:21,557days are all good or great. Principle number three my basic 27300:21:21,577 --> 00:21:25,131principles I don't sweat the small stuff, and most stuff is 27400:21:25,171 --> 00:21:29,579small. What I have learned is that when I get upset or about 27500:21:29,619 --> 00:21:33,377to get upset about something, nine times out of ten it's going27600:21:33,377 --> 00:21:36,128to be something that's relatively small, it's going to 27700:21:36,148 --> 00:21:39,436be something I can let go and it's not that big a deal. And 27800:21:39,517 --> 00:21:44,012I've learned to pause and go more slowly. Don't do it all the27900:21:44,012 --> 00:21:48,208time, but I'm better at evaluating those situations than28000:21:48,208 --> 00:21:53,281I used to. Principle number four forgiveness is therapy. 28100:21:54,244 --> 00:21:56,851Many times in life, certainly inhealthcare, whether it be a 28200:21:56,892 --> 00:22:00,039patient or whether it be a fellow caregiver individuals 28300:22:00,079 --> 00:22:04,295will say or perceptibly do things to you that you believe 28400:22:04,395 --> 00:22:09,432were not in your best interest. My suggestion to you is to 28500:22:09,511 --> 00:22:12,726forgive them. Has nothing to do with who's right or wrong, has 28600:22:12,766 --> 00:22:16,675nothing to do with the facts. Just forgive them and you would 28700:22:16,695 --> 00:22:21,530be amazed at how not only that is empowering for you, but how 28800:22:21,651 --> 00:22:25,641therapeutic that is for you as you move forward and try to make28900:22:25,641 --> 00:22:30,935the world a better place. And basic principle number five that29000:22:30,935 --> 00:22:33,981we've been talking about already everything is a 29100:22:34,041 --> 00:22:38,297relationship. Everything is a relationship. Today we talked 29200:22:38,336 --> 00:22:42,672about the caregiver-patient relationship, but my suggestion 29300:22:42,712 --> 00:22:45,478to you, whether it's doctor-patient, whether it's 29400:22:45,878 --> 00:22:50,974husband and wife, parent, child co-worker, co-worker, boss, 29500:22:51,655 --> 00:22:55,343employee relationships are basedon the same thing mutual 29600:22:55,363 --> 00:23:00,358respect, mutual trust and good communication. If you have those29700:23:00,358 --> 00:23:04,636three things, you have a strongand a viable relationship. If 29800:23:04,696 --> 00:23:09,372you do not, then you need to work on the areas of how, work 29900:23:09,432 --> 00:23:12,680on the areas that you can improve to get that relationship30000:23:12,680 --> 00:23:17,476to where it should be. Final thought be the change you want 30100:23:17,496 --> 00:23:22,291to see in the world. Be the change you want to see in the 30200:23:22,352 --> 00:23:23,900world. Have a great day. 30300:23:24,644 --> 00:23:26,452Speaker 1: Thanks for listening to the Healthy, wealthy and Wise30400:23:26,452 --> 00:23:31,548podcast with Dr William Choctaw, mdjd. We hope you enjoyed this30500:23:31,548 --> 00:23:34,461episode and, if you found it helpful, you can support and 30600:23:34,500 --> 00:23:37,993subscribe to the podcast on yourfavorite podcast platform. Look30700:23:37,993 --> 00:23:42,145at the words, dr William Choctaw, click on the. Support 30800:23:42,165 --> 00:23:46,936the show and you've got it. Thiswill also help ensure that you 30900:23:46,977 --> 00:23:50,932don't miss any future episodes, and then share this podcast with31000:23:50,932 --> 00:23:54,488your family, friends and all your co-workers. They'll be glad31100:23:54,488 --> 00:23:58,811you did So. Until the next time, live your best possible life 31200:23:59,112 --> 00:24:00,432the best possible way.