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Use your Imagination

Think of an apple, a sunset, the face of a loved one; what do you see? For some, the pictures in the mind’s eye will be vivid and clear, whilst others may see blurred impressions or individual features. But now scientists have identified a condition which results in people being unable to visualise mental images.

Called aphantasia, the condition was identified by a team of Exeter University researchers led by Prof Adam Zeman. Commenting on the research, Prof Zeman said the condition is not uncommon, affecting up to 1 in 50 people but that having aphantasia, or its opposite hyperphantasia, makes quite an importance difference to people’s experience of life.

As with many other conditions, the way in which it affects people’s lives will vary. Some may find it life limiting, whilst for others it is just the way they are. And the condition certainly doesn’t mean people lack imagination; it just means that they are unable to form visual images inside their head.  In a way this puts it in the same category as having excellent or virtually non-existent spatial awareness, being good or poor at map reading, having a good ear for music or being tone deaf. In other words, they are conditions which you were born with and there is not a lot that you can do to change them.

But there are other areas in life which we do have the power to change but which can sometimes seem so intrinsic to our lifestyle that we never think of doing so. Take the long work hours scenario for example. Particularly when we own our own business, it is all too easy to become sucked into a mindset which sees throwing hours at the problem as the only solution. When we start out, we do everything simply because we are looking to control costs and we do have some spare time. As the business grows, rather than looking to outsource some of our work we simply shorten our lunch hour or add-on a little time in the morning or evening. Then we add on a bit more time and a bit more until every spare moment is taken up in administration.

It doesn’t have to be like this. Stop for a moment and think about how you envisaged the business to be when you originally set out. Now take some steps to move business reality closer to your imagination. Do you need to rush to answer phones or could you outsource calls, does your diary have to sit on your desk or could it be managed by others, and do you really have to spend every evening in telephoning clients to remind them about their appointments or could this be managed in another way?

Being honest, we all have things about us that we would rather change. Some of them arise directly from our chromosomes and we might as well just get on and do the best we can with the hand we were dealt. But in other areas we can be our own worst enemy and perhaps it’s time to take positive action in pursuit of a more balanced lifestyle.

Taking Time Off

When you spend all of your time looking after the health of others, it can sometimes be difficult to take time to look after yourself. There always seems to be one more patient to help, one more report to write, one more bit of paperwork to file before you can step out of the office and into home life.

In this, health professionals are not alone. A recent report by Simply Business revealed that 20% of the UK’s small business owners say they can’t afford to take a single day off work this summer whilst a further 30% plan to holiday near home to keep an eye on their business.

In fact, this problem of work-life balance is seen in many countries. A recent report by German researchers revealed that working outside of core hours on tasks such as checking emails can limit the ability to feel detached from work, leading to higher levels of the stress hormone allied to a feeling of increased tiredness.

Whether working as a sole trader or in a small business it can sometimes be hard to see where you can turn to reduce the workload. The last thing you want to do is to reduce your client base as that will reduce income so instead it is tempting to save up all those administrative tasks for the evenings and weekends. Of course, there is the option of taking on a part-time member of staff to help with the workload, but this can be a tricky balancing act.

Obviously, if you have a regular volume of extra administrative tasks to complete then a new member of staff may well be the answer. However, when the workload is irregular then you may not be able to justify adding to your team on a permanent basis and temporary members of staff will always be around to answer the telephone when it is ringing and you are with a patient.

But there is another way. Virtual assistant services can help to reduce the workload by taking on tasks such as telephone answering, appointment booking and records and diary management. Better still, by using a virtual assistant service you gain the flexibility which you require. For example, you can switch telephones over to the virtual service when you are with clients or on holiday, switching them back when you are free to answer calls.

Tasks such as phone answering and appointment booking can easily intrude on daily business life and create a pressure point which can add to stress levels. Not having to answer the telephone when you are treating patients or meeting with clients, being able to access client notes online rather than spending time in preparing for meetings, even having someone to screen out unwanted sales calls can all make a difference to the working day and to peace of mind.

Of course, at the end of the day virtual assistant services can only go so far in helping to improve the work-life balance. The bottom line is that as a business owner you owe it to yourself, to your family and to your clients to take the time off that you need to refresh the mental and physical batteries. If you don’t, your work will suffer and that helps no-one.

Bank Holiday Toil

Don’t hold your breath but it seems as though we may be in for some spells of sunshine this bank holiday weekend.  Of course it is nearly the end of May so we are due some sun time but the forecast does open up additional possibilities for bank holiday activities.

Whilst some of us will be heading towards the beach or the park, others may have a full sporting calendar, either taking part or cheering on our favourite team.  Those with children who are taking GCSE or A ‘level exams this year may be facing a more sedentary time as the final chance for revision looms large over the household.

But  for many, this bank holiday weekend is traditionally a time for DIY or for gardening, for clearing out and tidying up, for moving plants and revamping flowerbeds in a bid to get our homes and gardens in top shape for the summer.   This is the weekend when despite our best intentions we do just that bit too much and our bodies let us know in no uncertain terms.  In fact in 2006 some 87,000 people were treated in hospital in the UK as a direct result of gardening accidents with lawn mowers and flower pots topping the list of causes.

Whilst trips and falls may require urgent attention, back and other muscle strains can take a few days to come through but when they do they can require ongoing therapy.  So much so that the Physiotherapy website comments that at this time of year physiotherapists, osteopaths and chiropractors all see an upswing in demand due to gardening injuries.  That site offers a list of eleven handy hints to reduce the occurrence of problems including warming up, using good lifting techniques and taking planned breaks

With the best will in the world even if everyone followed the suggestions there would still be an increase in demand as muscles and ligaments creak under the strain of unaccustomed exercise. This in turn places an increased demand on health professionals such as physiotherapists, chiropractors and osteopaths; all of whom may well see a significant increase in demand for their services in the period after bank holidays. So what can health professionals do in turn to reduce the strain on their own resources.  Our handy hints would include:

  • Offer an online booking facility.
  • Opt for secure card processing.
  • Manage your diary online.

…and of course, call in a virtual assistant service to answer routine calls when you are busy. These measures will all help to cut down on the volume of calls to the practice, thus freeing up time which can be spent in treating those bank holiday injuries. Online booking and diary management allied to a virtual assistant service enable prospective patients to book appointments quickly and easily without impinging on ongoing treatments. Adding secure card processing to the mix not only helps to speed up payment collection times and reduce paperwork, prospective patients who hand over card details at the time of booking are less likely to miss their appointments.

Let’s hope that the forecasters have got it right this weekend and that we can all enjoy some time in the sun without paying too dear a price afterwards in terms of painful joints or in too great a call on our services.

Business Spring Cleaning

The second week in March has sadly not lived up to the promise of the first with cold, wet and dull weather taking the place of sunshine. Nevertheless spring is well on the way and with it our thoughts turn to the annual challenge of spring cleaning.

No-one knows where the tradition of spring cleaning started. The practice has been shown to have roots in several ancient cultures but it is almost tempting to speculate that even back in cave dwelling times, ancient people stepped out from the crevices in the rocks which had given them winter shelter, sniffed the fresh air of spring and started to clean.

But there is a darker side to spring cleaning. As we vacuum and scrub, mop dusty floors and persuade over-wintering spiders to leave the home, the emergency services are poised waiting for the call. Every year, casualty departments are called on to treat those of us who thought that balancing on a rickety chair or table would be a good idea when cleaning windows or reaching high ceilings. Others will have to call on the services of physiotherapists or osteopaths to help sort out sprains and strains caused by repetitive movements such as overenthusiastic dusting or polishing.

With health professionals such as physiotherapists being stretched by all of these seasonal injuries, it may be time for them to carry out a little spring cleaning of their own. When we start out in business we tend to adopt coping mechanisms, working through processes which may cost us in time but save cash flow. With more mature businesses it may be time to spring clean some of these practices, bringing processes up to date.

For example, in the early days with few clients it can be a simple matter either to hope that they will turn up for appointments or phone them with a reminder.  Growing businesses which try to continue this practice may well be spending time on client reminders which would be better spent on treating a growing client base.  And in truth, what business nowadays can afford to operate under a model which allows for gaps in appointment times when clients fail to turn up. Simple remedies such as SMS text reminders, the availability of online booking and switching phones in busy times can free up a significant amount of time.

SMS text reminders also help to cut down on no-shows, but it still leaves businesses open to the possibility of a reduction in income, should clients fail to turn up for their appointments. One practice which can help to alleviate this problem is the taking of credit or debit card details at the time the appointment is made. When clients turn up for their appointments the card payment can simply be confirmed, considerably smoothing out the invoice/administration process. However, should clients fail to attend appointments; a no-show fee can still be taken in accordance with the health practice’s publicised tariff.

As we are looking at spring cleaning for efficiency, ask yourself if it is really necessary to have all of those paper records cluttering up the office?  Electronic filing can not only help to clear away paperwork, with patient records available at the touch of a button it can also help to save time when clients come to call.  It doesn’t take much to spring clean business processes, but health professionals may find that taking a little time out to review the way the practice is set up now could make a measurable difference in the future

Advancing Recovery through Electronic Filing of Medical Records

Not so long ago a broken hip would result in weeks or even months of hospitalisation as the bones were left to slowly knit together. Nowadays the broken hip is simply replaced, leading in many cases to discharge in a matter of days followed by recuperation at home.

Admittedly that recuperation requires the help of support services with physiotherapy and exercise advice being supplemented by aids such as walking frames but the new regime is far more effective and far better for the long term health of the patient. The patient is spared the challenge of being confined to bed for weeks and scarce hospital beds are freed up quickly.

But this new regime does bring with it the challenge of moving support services away from the hospital and in to the wider community.  Local health practitioners including physiotherapists are now seeing an increase in demand from patients who previously would have relied on in-hospital services. Depending on the health authority, those requiring rehabilitation and physiotherapy treatments may be offered outpatient appointments at a central or local hospital, treatment in local specialised centres or even home visits from mobility specialists. Whilst this range of options is designed to improve patient outcomes, it does require an increased focus on effective patient treatment plans and the sharing of information.

Luckily, whilst technological improvements have enabled swifter treatment of patients, they have also enabled health practitioners to remove some of the burden of non-essential tasks as well as streamlining data and information sharing. Take patient records for example.  Paperwork has been a perennial challenge for the health profession.   Countless hours which should have been spent in patient treatments have been wasted as records are transferred from one treatment centre to another or are stacked up on administrator’s desks whilst skilled typists struggle to interpret scribbled notes.

Even simply filing and retrieving records can take up time which would be better spent in focusing on patient needs whilst the mobility of patients around treatment centres has increased the danger of patients being lost in the system. Now, thanks to the advent of electronic filing, much of the unproductive time is no longer wasted.  Electronic filing not only reduces instances of mis-filing, it also enables records to be transferred between treatment centres and then brought to hand swiftly as and when required.

With clinical notes organised and important test results and x-rays available on screen at the touch of a button, health practitioners can not only maximise patient treatment times, they can start treatment programmes in a timely manner without having to wait for records to be transferred by post or hand delivered.  Link in online diary management or on-line booking services and yet more time which was previously spent on administration is freed up.

Such is the pace of technological change that medical breakthroughs are coming thick and fast, transforming health services and enabling patients to recuperate at home where once they blocked beds.  With administration also reduced thanks to technology, the face of the health service in years to come will be a very different one from that which in the past was bedevilled by paperwork and the delays and frustrations occasioned by filing, retrieving and transporting patient records.

Seasonal Flu

Autumn may have started with a blaze of sunshine but hopes of lingering summer weather have now been well and truly dashed by the arrival of storms and heavy rain. It’s a stark reminder of the longer nights, dwindling temperatures and gradual descent into frost and slush that we will have to endure before summer once again peeps over the horizon.

The arrival of Autumn also heralds the start of this year’s flu jab campaign.  According to Public Health England, only 52% of those with an underlying illness took up the free jab offer last year (2013) and PHE are keen to increase that percentage as much as possible this winter.

So the call has gone out for young children, the elderly and those with underlying conditions to take up the challenge and get protected.  Professor Dame Sally Davies, the Government’s Chief Medical Officer said “I would urge those who are offered the free flu vaccination to visit their GP early in the flu season. I also urge all health care workers to make sure they are vaccinated to protect themselves, their patients and their families.”

When we think of the flu jab we naturally tend to think of it in terms of prevention of the flu itself but there are a number of other consequences of flu which put a strain on our health services. One of the more common of these is the need for some form of osteopath or chiropractic treatment as muscles or ligaments become strained thanks to the effects of coughing. When we cough or sneeze we put a tremendous percussive force on our bodies and this can lead to back and other injuries.

The effect of this is that not only do health practitioners need to stay healthy themselves to continue to treat their normal patients, they also have extra calls on their time to treat these flu-related injuries. And really these couldn’t come at a worse time.  One good bout of overnight frost and icy pavements add to slips and falls whilst icy roads lead to crashes.  These too put a strain on our health services with physiotherapists and other health practitioners having to cope with the aftermath of broken bones and strains.

Of course, if we all took up the flu-jab challenge then our health service would be far better off but as that is an ‘ideal world’ scenario it means that once again our health services may be stretched this winter.  Anything which can help to mitigate that pressure is therefore welcome and that is why numbers of health practices are adopting ways of working which will reduce the strain on their own resources.  Areas such as electronic filing of records, appointment reminders and the use of virtual assistant services to answer calls and book appointments can all help to smooth out administration time and therefore add to the time available for treatment.

As Public Health England says “Each winter hundreds of thousands of people see their GP and tens of thousands are hospitalised because of flu.” That puts a huge strain on resources so it’s no wonder that they are campaigning for as many people as possible to be vaccinated this year.

The cost of health

The Royal College of Nursing (RCN) has overwhelmingly rejected a proposal to charge patients for NHS appointments.  Had the proposal been successful it would have led to the RCN backing the idea of a £10 charge for health appointments, but in the end 91% of delegates at the RCN conference voted against.

Those in favour of the proposal said that making a charge would not only raise much needed revenue for the NHS it would also emphasis the value of NHS appointments.  In other words, charging for appointments would help people to appreciate the value and cost of NHS appointments and in the process make people think a little more about the way in which they use NHS resources This would in turn, the proponents argued, result in the twin benefits of reducing unnecessary appointments and reducing no-shows; both of which waste considerable NHS resources as well as potentially delaying urgent treatments. After all, it helps no-one if health practitioners are sitting idly by waiting in vain for someone to turn up. That time would far better be used in helping another patient.

Commenting on the vote a spokesperson for the Department of Health said “We are absolutely clear that the NHS should be free at the point of use, and we will not charge for GP appointments.”  But with no-shows a constant drain on both NHS and private health care services, practices are increasingly turning towards the use of appointment reminders as a means of encouraging people to attend booked appointments or to cancel them in good time.

Sent by phone, SMS text or e-mail, appointment reminders not only jog patients’ memories, they also act as a spur for patients to get in touch and cancel appointments if they are unable to attend.  This in turn enables health practices to re-book appointment slots.

For health practices such as osteopaths or physiotherapists which do charge for appointments, not only do no-shows waste valuable treatment time, they also act as a cost drain on the practice.  Whilst the option of sending out appointment reminders is one option, another great way to cut down on no-shows is to take a secure card pre-authorisation at the time the appointment is booked.  Having a card pre-authorised tends to sharpen the mind when it comes to remembering to attend appointments. Pre-authorising a card doesn’t prevent the patient from paying by other means when they attend the appointment but should the patient not attend the health practice can charge a pre-agreed sum to the card.  Pre-authorised card booking can be taken either over the phone or when an appointment is booked online.

With a report from the BBC revealing that the NHS may be facing a funding gap of some £2billion in the next year, we suspect that the debate about the way in which health care is funded and managed will rumble on for some time.  Adopting systems such as appointment reminders which help to ensure patient care is delivered when it is required whilst at the same time maximising resources can only be a positive move.

Mustn’t Grumble

In a survey to mark Dementia Awareness Week (18-24 May) the Alzheimer’s Society revealed that 54% of people had waited for six months or more before seeking professional help  for signs of dementia.  The time delay appears to be fairly similar in respect of all health conditions with a separate YouGov poll reporting that 57% of adults who had had a health problem in the past year had put off asking for help.

Reasons given for the delay include a reluctance to make a fuss (47%), the fear of having a serious health problem (23%) and embarrassment (22%).  Delays in reporting in particular relate to dementia, heart and digestive problems.

Commenting on the survey, Alzheimer’s Society Chief Executive, Jeremy Hughes acknowledged the difficulty which people have when confronting diseases such as dementia but went on to say that “the sooner you know what you are dealing with, the sooner you can feel in control again and get on with your life.”  But the delay factor doesn’t just affect those with potentially serious illness.  For every patient who seems to live in the surgery, another will hold off reporting even persistent complaints.

This can lead to minor strains or injuries being exacerbated up to the point at which they become debilitating.  When patients do finally pick up the phone, if they don’t receive an instant answer, they may drop the idea of further help.  This means that prompt telephone answering is not just vital for health professionals such as doctors and dentists; other professionals such as chiropractors, podiatrists and physiotherapists all have a responsibility to ensure phones are answered as swiftly as possible.

For smaller practices this isn’t always as easy as it sounds.  Curtailing a treatment to answer the phone is not only unprofessional, it can in some cases result in further damage occurring.  And whilst some patients may be prepared to leave their details on an answerphone, many will be reluctant to do so. This is particularly the case when someone has delayed asking for help; the unanswered call acting as a trigger to retreat away from the decision to seek help and back towards trying to manage the condition without outside intervention.

The solution is to link up with a virtual receptionist service.  Virtual receptionists can answer the phone and make appointments on behalf of the health practice, leaving the practitioner free to concentrate on what they do best, helping people to recover from illness or injury. Not only does this help to ensure that treatment plans are carried out smoothly and without interruption, it can also free up vital time which can be used in treating additional patients.

One in three people over the age of 65 will develop dementia and it’s a fair bet that almost 100% of people within the same age bracket will develop strains, foot problems or other similar treatable problems at some time or other.  Taking steps now to help them to contact a health professional easily and swiftly may just help to prolong their overall health in times to come.

Back to basics

A global research study has concluded that lower back pain is the leading cause of disability and work absence across much of the globe.  Researchers from institutions in Australia, the US and the UK including the Royal Cornwall Hospital found that whilst there is no evidence linking back pain with a higher risk of early death, it can cause long term disability.

Across the world the study estimates that nearly 1 in 10 suffer from lower back pain with the figure rising to 15% in Europe.  An increasingly aging population is only going to exacerbate the issue which can cause emotional and financial as well as health problems for sufferers.

Although lower back pain has no one common trigger point, typically causes include poor posture when sitting or standing, bending awkwardly or failing to follow lifting guidelines.  Acute back pain can also cause leg pain which adds to the difficulty of moving and walking.  In its extreme form it can also impact on everyday tasks such as washing or dressing.

With the incidence of lower back pain expected to increase alongside an ever-aging population this condition places a strain on all health professionals.  Whilst doctors and health visitors are more likely to be in the front line, others such as physiotherapists, osteopaths and chiropractors will all take up the burden of day to day treatment.  Maximising patient time and minimising administrative burdens will therefore form an essential part of the way forward in treating this debilitating condition.

For the health professional this will require a switch to “always on” technology which will help patients to book appointments and stay in touch without taking up clinical time.  This includes taking steps to ensure phones are covered by internal or external support staff, appointment booking online and automatic appointment reminders.  These simple steps can make a huge difference both to treatment times and to ease the strain on overworked health professionals.

In its review of the study, the NHS Choices website concludes that it may be a cliché to say that doctors don’t understand the back but it acknowledges that lower back pain is a “poorly understood condition.” The site therefore calls for further research into the ways in which back pain can better be prevented and managed.  Pending the outcome of such research it will fall on health professionals to take steps to manage their back pain management in the most effective way possible.

Changing the UK’s Health

Sometimes for change to happen it requires a seismic shift in technology or actions, but on other occasions a series of small individual acts can come together to create something special.  That was the idea behind NHS Change day; a time when individuals can make small pledges which could result in significant change for the NHS.

At the time of writing over 450,000 people have made their pledges and with the last pledge date for 2014 still some weeks away the final total is expected to be far higher.  Some pledges are designed to support and strengthen local campaigns whilst others have been made on a far more individual basis.

One national campaign which the NHS is promoting through NHS Change Day is the idea of reducing no-shows.  With 12 million GP and 6.9 million hospital appointments missed in the last year costing a total of £270m, every person who makes an individual pledge not to miss an appointment in future will be saving the NHS money and improving treatment for themselves and others.

In an attempt to cut down on no-shows NHS practices are adopting a range of measures from reminder calls and texts to encouraging direct booking online.  But it is not just health practitioners within the NHS who suffer from missed appointments.  Health practitioners across the board from chiropractors to physiotherapists and from beauticians to counsellors all suffer if a patient fails to attend an appointment.  And in many of these cases it is not just the taxpayer who loses out but the health practitioner themselves, not to mention other patients who could have taken that vacant slot.

So for health practices everywhere, anything which can be done to cut down on no-shows should be done.  Appointment reminders, online booking services, ensuring continuity of telephone answering; all can play their part in working towards a full diary and effective treatments.

The pledges being made for NHS Change day are not just confined to reducing missed appointments.  Challenging culture, enhancing leadership, patient safety, improving skills, the list goes on.  Some of the pledges are from patients, others from those on the front line or back office who are working to improve the NHS from within and without.  From individual pledges to walk more or eat healthily to sharing knowledge and experience with others, the pledges may individually not be earth shattering.  But if enough people see the pledges and join in then health care for all could be the winner.

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