Nov. 13, 2023

Mastering Your Healthcare Decisions: A Comprehensive Guide to Advanced Directives with Dr. William Choctaw

Mastering Your Healthcare Decisions: A Comprehensive Guide to Advanced Directives with Dr. William Choctaw

Want to take control of your healthcare decisions? Join us as we open the door to the crucial world of advanced directives with Dr. William T Choctaw. Together, we guide you through the labyrinth of these legally binding documents, from living wills ...

Want to take control of your healthcare decisions? Join us as we open the door to the crucial world of advanced directives with Dr. William T Choctaw. Together, we guide you through the labyrinth of these legally binding documents, from living wills to medical power of attorney, dissecting their intricacies and importance. We discuss how hospitals are obligated to ask about these directives to ensure your personal needs are met and why validating these documents is a must. 

Moving onto the tough subject of end-of-life discussions, we share Dr. Choctaw's invaluable wisdom on how to navigate these delicate conversations. We delve into the role an appointed agent plays in making decisions on a patient's behalf, and the various aspects you need to consider. Wrapping up the episode, Dr. Choctaw leaves us with his inspiring five principles for life and your cue to continue your journey of discovery with our Health, Wealth, and Wise Podcast. Don’t miss this opportunity to gain essential insights and become the master of your healthcare decisions.

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The Host, Dr. William Choctaw; MD, JD, is a healthcare leadership expert, possessing a Medical Doctorate from the Yale University School of Medicine, and a Jurist Doctorate from Western University. Over a span of 50 years practicing medicine, he has served as Chief of Staff, Chief of Surgery, and as a member of the medical executive committee at Citrus Valley Medical Center over a 10 year period. Also, while practicing at Citrus Valley Medical Center, he served as Chief Transformation Officer, (developed a Robust Process Improvement/Lean Six Sigma program). Dr. Choctaw lectures nationally and internationally on medical leadership issues for hospital staffs, executives, and managers. He served as a Physician Surveyor on the Joint Commission. He's the author of 2 books, "Medical Malpractice: A Physician's Guide to the Law" and "Transforming the Patient Experience: A New Paradigm for Hospital and Physician Leadership, published by the Springer Publishing Co. He’s the President of Choctaw Medical Group, Inc., a clinical practice and medical legal consulting firm for medical staff executives, physician leaders, and hospitals.

Transcript
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.