Qualities of surgeons to look for

Here are some qualities that I admire in surgeons when they do their operations in the operating room (with the assumption that the outcome is good and there is adequate anesthesia):

1. Finesse
2. Speed and without too many unnecessary moves
3. Decisiveness
4. Cost-effectiveness

Here are the some qualities that patients usually admire surgeons when the latter do procedures when they are awake (with the assumption that the outcome is good and there is adequate pain control):

1. Gentleness (magaan ang kamay)
2. Speed (mabilis)
3. Decisiveness
4. Cost-effectiveness

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ROJ-TPOR@18sept2

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Aphorism and Adage and Maxim – ROJoson

August 8, 2018

Definition of APHORISM:

A concise statement of a principle; a terse formulation of a truth or sentiment.

https://www.merriam-webster.com/dictionary/aphorism

History of APHORISM:

Aphorism was originally used in the world of medicine. Credit Hippocrates, the Greek physician regarded as the father of modern medicine, with influencing our use of the word. He used aphorismos (a Greek ancestor of aphorism meaning “definition” or “aphorism”) in titling a book outlining his principles on the diagnosis and treatment of disease. That volume offered many examples that helped to define aphorism, beginning with the statement that starts the book’s introduction: “Life is short, Art long, Occasion sudden and dangerous, Experience deceitful, and Judgment difficult.” English speakers originally used the term mainly in the realm of the physical sciences, but eventually broadened its use to cover principles in other fields.

https://www.merriam-webster.com/dictionary/aphorism

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Aphorism, Adage and other Terms 

Aphorism, adage, proverbs, maxims, byword, saying, etc. are commonly used interchangeably or synonymously.

For the purpose of my writings, I will limit myself to aphorism and adage and maxim.

• Aphorism – a concise definition, notably memorable.
• Adage – an aphorism that has gained credibility by virtue of long use.
• Maxim – a rule of conduct

https://en.wikipedia.org/wiki/Saying

To simplify things, I will just use Aphorism / Adage or Aphorism-Adage if I cannot determine which ones (the published ones) are memorable and which ones have been in long use.  If I created my own concise statement of a principle or a terse formulation of a truth, I will use the term “APHORISM.”

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• ROJoson’s Aphorisms-Adages and Maxims on Living Life (Subscribed to and Created)
• ROJoson’s Aphorisms-Adages and Maxims on Being a Physician
• ROJoson’s Aphorisms-Adages and Maxims on Being a Surgeon
• ROJoson’s Aphorisms-Adages and Maxims on Medical Education
• ROJoson’s Aphorisms-Adages and Maxims on Surgical Education  
• ROJoson’s Aphorisms-Adages and Maxims on Hospital Administration

Action Plan: From August 8, 2018 to January 15, 2019, will formulate 10 aphorisms-adages and maxims for each of the 6 categories (before my graduation day on January 31, 2019)

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ROJoson’s Aphorisms-Adages and Maxims on Living Life (Subscribed to and Created)

• Let us value the quality of life, not the quantity.
• The best apology is a changed positive behavior.
• When you do something out of love, you don’t count the cost.
• Aspire to inspire before we expire!

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ROJoson’s Aphorisms-Adages and Maxims on Being a Physician

• Cure sometimes, relieve often, comfort always.

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ROJoson’s Aphorisms-Adages and Maxims on Being a Surgeon

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ROJoson’s Aphorisms-Adages and Maxims on Medical Education

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ROJoson’s Aphorisms-Adages and Maxims on Surgical Education

 

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ROJ@18aug8; 18aug11

Minimalist vs Maximalist Person and Physician

ROJoson’s Concepts:

Minimalist Person – a person acquiring things that are only essential and needed to living a simple comfortable life (keeping things to the minimum or essential).

Maximalist Person – a person acquiring things even those which are not essential and needed in living a simple comfortable life.

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Minimalist Physician – a physician instituting medical management only those which are essential and needed by a patient in health restoration and maintenance.

Maximalist Physician – a physician instituting medical management including even those which are not essential and needed by a patient in health restoration and maintenance.

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Groopman Spectrum

http://birthtools.org/birthtools/files/BirthToolFiles/FILENAME/000000000146/The-Groopman-Spectrums-Understanding-Your-Biases-and-Orientation-in-Medical-Decision-Making.pdf

Determine whether you’re a maximalist or minimalist. Some patients (and doctors) believe that the most treatment is the best treatment. Dr. Groopman tends to be one of them. For example, many years ago, he underwent a spinal fusion because he was convinced that medical science could identify the cause of his back pain and fix it. (It was a mistake—he has suffered from severe back pain ever since and is now somewhat less of a maximalist.)

Dr. Hartzband is a medical minimalist. She never rushes to have tests or procedures. She errs on the side of avoiding medical care until she is convinced that she needs it.

Both approaches are valid as long as you are willing to adjust your thinking as you go along. A maximalist needs to remind himself/herself that it’s sometimes better to slow down, to think twice before agreeing to a particular treatment. A minimalist needs to keep in mind that it is sometimes better to see a doctor today rather than next week or to have a test that he/she would rather avoid.

https://bottomlineinc.com/health/wellness/are-you-a-medical-maximalist-or-a-minimalist-and-other-questions-to-help-you-choose-the-right-treatment

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NOTE: I am a minimalist person and physician.

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ROJ@18jul25

PQA Criteria for Performance Excellence 2017 – 2021

PQA Healthcare Criteria for Performance Excellence 2017 – 2021

2017-2021-pqa-healthcare-criteria-ver01-39

PQA Education Criteria for Performance Excellence 2017 – 2021

2017-2021-pqa-education-criteria-ver04-06182018-50

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ROJ@18jul23

Reviewing ROJoson’s Facebook Project on its 7th Anniversary – June 16, 2018

I officially started using Facebook on June 16, 2011.

June 16, 2018, my Facebook Project is 7 years old and going on its 8 years.

On its 7^th anniversary, I will make a review and evaluation.

In the past, I already made several evaluations (2011 December – 6 months after usage; 2013 – 24 months after usage; 2014 – 3 years after; 2015 – 4.5 years after; 2016 – 5 years after usage).  The overall result has always been positive and my friends have consistently wanted me to continue my Facebook Project or Postings.

In 2014 and 2016, I asked for formal feedback through a survey from my friends in Facebook.  The results can be seen in the following links (with 38 and 119 respondents respectively):

https://docs.google.com/forms/d/1-Fk7dQw4e8P08dPL_zpcs30AuyLJ41EFvp5Pt0B7Dv8/viewanalytics

https://docs.google.com/forms/d/1VCMZ0iYpDfLNDxkerOCtri-Y40kVdzzH6UuS0OVNkaU/viewanalytics

I will not conduct another survey to get feedback anymore this year.  Instead, I will just make an informal personal evaluation of my Facebook Project based on my formulated goals and objectives and observed outcomes.

The following was my first post in my homepage (profile page) in Facebook on June 16, 2011, spelling out the objectives and contents of my Facebook:

“My Facebook will contain my thoughts, perceptions, opinions, and recommendations (TPORs) on things of interest to me and on things that may be of interest and concern to my patients, to my colleagues, to my friends, and to my family.” 

Evaluation:

I have fulfilled all the objectives that were set at the start, namely:

“My Facebook will contain my thoughts, perceptions, opinions, and recommendations (TPOR) on things of interest to me and on things that may be of interest and concern to my patients, to my colleagues, to my friends, and to my family.” [I have “likes” and “comments” from all of my intended readers.]

I have been using the Facebook as a personal blog to:

o   Facilitate communication and keeping in touch with my patients, students, colleagues in the medical profession, classmates, friends, and with my family;

o   Advance my advocacy on “Education for Health Development in the Philippines,” which I started in 1989;

o   Share on my personal thoughts, perceptions, opinions, and recommendations (TPORs) in the following four areas: Medicine; Hospital Administration; Medical Education; and Life. (with focus on the following specific topics: Breast Wellness; Thyroid Wellness; Hospital Quality Management  System; Hospital Safety Promotion and Disaster Preparedness Program; and Problem-based Learning in Medicine and Surgery.) 

The missions of my Facebook Project are spelled out as such: to infoshare; to inspire; to improve.

Infoshare means to inform and share information and my TPORs (Thoughts, Perceptions, Opinions and Recommendations) which will lead to the other missions to inspire and to improve.

Inspire means to motivate changes for the better or learning on the part of my friends or readers.

Improve means to produce positive changes in behavior (learning) which is the ultimate target of my Facebook Project and Blogs, that is, Education for Health Development in the Philippines Program.

I am achieving the missions of my Facebook Project as evidenced by the responses of friends in my Timelines and the increasing number of requests to be connected or to follow me.

I have reached the 5000-friend Facebook Timeline quota in June 2017.  I have created an extension in the form of group page (Reynaldo O Joson 2).  As of June 18, 2018, 1030 am, there are 675 friends subscribed in this group. 

I am also achieving my OCIL objective in my Facebook Project.  OCIL stands for Online Collaborative and Interactive Learning. I started this in 1999 to conduct online learning sessions particularly with surgical residents, medical students, and students in hospital administration. Google “Online Collaborative and Interactive Learning ROJoson” and you will see the links.

One link is: https://rojosonocilonhospitaladministration.wordpress.com/2014/03/07/online-collaborative-and-interactive-learning-program-in-a-hospital-setting-rojosons-recommendations/

OCIL is learning being effected collaboratively with online interaction not only among the learner-participants but also with the facilitator. As the facilitator, I work on the premise that I don’t know everything though I know something on the learning topic and I recognize the importance of the help of my learner-participants through collaboration and interaction in coming out with a most fruitful learning session.

I have extended this OCIL (though informally) when I started using Facebook in 2011. 

For details on my FACEBOOK PROJECT, visit: 

https://rojosonfacebooknotes.wordpress.com/category/facebook-project-rojoson/

RESOLUTIONS:

1. Will continue my Facebook Project with the same goals and objectives and missions until I become disabled, crippled or die or until Facebook closes down (pray and hope not).
2. Will welcome more “friends” and “followers” probably at an increment of at least 500 per year in Reynaldo O Joson 2.
3. Will try to increase or intensify collaborative and interactive learning from “friends” and “followers.”

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ROJ@18jun18

Evaluation of ROJoson’s Facebook Project – After 6 Months of Usage

Posted in December 2011

I officially started using Facebook on June 16, 2011.  Today, December 17, 2011, I am doing an evaluation after 6 months of usage.

The following was my first post in my homepage (profile page) in Facebook on June 16, 2011, spelling out the objectives and contents of my Facebook:

“My Facebook will contain my thoughts, perceptions, opinions, and recommendations (TPOR) on things of interest to me and on things that may be of interest and concern to my patients, to my colleagues, to my friends, and to my family.”

Aside from a profile page (homepage), I created “pages” and “groups.”

The following “pages” have been created:

• Hospital Safety Promotion and Disaster Preparedness Program
• ROJoson Medical Clinic
• ROJoson Breast Wellness Clinic
• Thyroid Wellness Clinic
• Medical Anecdotal Reports

The following”groups” have been created:

• MDH-ORC Safety Promotion and Disaster Preparedness Program
• Hospital Safety Promotion and Disaster Preparedness Program
• MDH Safety Promotion and Disaster Preparedness Program
• MDH Sharps Safety and Waste Management System
• Friends of ROJoson Medical Clinic
• ROJoson Family

 

Data as of December 17, 2011:

Evaluation and Action Plans for Improvement:

1. I have fulfilled all the objectives that were set at the start, namely:

“My Facebook will contain my thoughts, perceptions, opinions, and recommendations (TPOR) on things of interest to me and on things that may be of interest and concern to my patients, to my colleagues, to my friends, and to my family.” [I have “likes” from all of my intended readers.]

I have been using the Facebook as a personal blog to:

o   Facilitate communication and keeping in touch with my patients, students, colleagues in the medical profession, classmates, friends, and with my family;

o   Advance my advocacy on “Education for Health Development in the Philippines,” which I started in 1989;

o   Share on my personal thoughts, perceptions, opinions, and recommendations (TPORs) in the following four areas: Medicine; Hospital Administration; Medical Education; and Life. (with focus on the following specific topics: Breast Wellness; Thyroid Wellness; Hospital Quality Management  System; Hospital Safety Promotion and Disaster Preparedness Program; and Problem-based Learning in Medicine and Surgery.

2.      Difficulties identified:

• Archiving of TPORs and Notes posted.
• Keeping tab of statistics on“likes” in the Homepage and Group Pages.
• Still with incomplete or few members in the Group Pages.

3. Action plans.

• Create a site in WordPress.com to store the notes I posted in my Profile ( Homepage).  With categories to facilitate archiving and retrieval.  With site statistics.

Status: DONE

Created https://rojosonfacebooknotes.wordpress.comin July, 2011 with first posting on July 26, 2011.  Total posts as of December 17, 2011: 129.  Total views: 611.

Will put the wordpress.com url in my Facebook Hompage (DONE).

• Will strengthen the Group Pages by adding more members as indicated.
• Will put in more contents in the Pages, particularly on Medical Anecdotal Reports.
• Will consider creating more archiving sites in wordpress.com especially for the Pages to facilitate archiving.
• Will re-post or reiterate important TPORs in the Facebook at planned intervals, such as monthly or quarterly.

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ROJ@18jun18

Every person is insane or crazy in one way or another – what to do to control to promote mental health

Everybody is insane or crazy in one way or another.

This statement is supported by this article (see picture below).
https://www.livescience.com/5082-insane.html

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This insanity should be controlled so that 
– one can be happy and 
– one should not be a burden to family members and society.

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Some tips on how to prevent modern insanity (from: https://www.livescience.com/7835-modern-insanity-crazy.html)

– Get more Zzzzs

A century ago, Americans were averaging nine hours of sleep every night. These days, according to the National Sleep Foundation, many people get less than seven, a trend that has been linked to an overall decline in mental health. Strive to get 8 to10 hours of sleep each night to help your brain and body fully recuperate.

– Seek social support

While our distant ancestors likely enjoyed being the best at something, say the best gooseberry spotter among their community of 50 to 100 individuals, in “today’s global village of 6.5 billion people, nobody is the best at anything,” Ilardi said. Finding a niche in a subset community may dissuade this inevitable ego knocker as well as provide other mental health goodies, such as halting rumination.

– Interrupt circle-think

Focusing on a problem or discomfort can be adaptive; it helps us find solutions. But when we become fixated, the repetitive stress can erode our ability to rebound. Rumination, Ilardi says, is particularly common when we’re alone, a state familiar to many inhabitants of developed countries. In contrast, our ancient ancestors rarely went solo. Having company or partaking in engaging activities can stop ruminative thoughts in their tracks.

– Walk it off

We evolved as recreational athletes. Our ancestors not only spent much of the day engaged in moderate aerobic activity but also undertook regular weight-bearing chores, such as digging ditches and building huts. Studies have shown, just 90 minutes of exercise a week can be as effective as psych-medicines such as Zoloft.

– Develop a world view

While research on the relationship between religion and mental health is inconclusive, individuals who have a global framework — a way of understanding the world, whether it be religious, philosophical or scientific — may have an increased ability to withstand blows to their mental health, Ilardi said.

 

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Personal Resolutions
– Get enough and not too much sleep – 6 hours at least and 9 hours at most including siesta
– Seek social support – family, colleagues, friends and patients
– Control rumination
– Exercise – walk and stretching and flexing 
– Develop an understanding of life with acceptance of its imperfections

On “rumination” –

Rumination is one of the similarities between anxiety and depression. Ruminating is simply repetitively going over a thought or a problem without completion. When people are depressed, the themes of rumination are typically about being inadequate or worthless. The repetition and the feelings of inadequacy raise anxiety and anxiety interferes with solving the problem. Then depression deepens.

Rumination can be switched off by two good methods: 1) get out of the negative neural networks and 2) tackle one problem at a time with planning.

ROJoson’s Notes:

For the first one, I will do these as a priority:

– Interfering with rumination may be helped with a memory jogger for times I was feeling good by going over pictures and records of happy memories.

– I will try to get into new activities that will really make me feel good (music, movies, etc.)

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ROJ@18may4