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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.

From Sun Up to Sun Down

By the time that you read this article, the chances are that the US Masters golf tournament will be over and all of the speculation about whether Rory Mcllroy or one of the other front runners will triumph will have been answered. In the run-up to the tournament, apart from spotting potential winners, one of the main stories revolved around Tiger Woods and his return to the competition trail following treatment for injury from physiotherapists and other health professionals.

Commenting on his comeback Tiger Woods said “People would never understand how much work I put into it to come back and do this again, it was sun up to sun down.” His comments are hardly surprising, given the champion he once was.

Getting to the top in any walk of life requires a measure of determination and hard work and getting back to ones best after a set-back requires an extra measure of grit and courage. But such courage is not simply confined to top sportspeople. The determination to improve, to get better, to overcome injury or other setbacks comes from within and can be found in all walks of life. It’s something which physiotherapists and other health professionals see on a daily basis. Octogenarians recovering from a hip replacement, children regaining the use of broken limbs following a fall, the middle aged recovering from a rather too strenuous gardening session in the spring weather; whatever the reason, when we set our minds to a task it is surprising how the results will follow.

It is one of the key motivators and rewards of being in the health profession; seeing others improve, watching them stretching themselves to the limit in a bid to return to fitness. It also can be one of the prime challenges; balancing people’s desire to return to ‘business as usual’ against their ability to recuperate. Get the balance wrong one way and overwork could lead to a setback. Swing the pendulum too far towards caution and the ability to return to maximum mobility could be lost forever.

Getting the balance right, deploying your professional skills to the benefit of patients is challenging but success can be personally rewarding. Discharging an individual from your care as they step out renewed to live as full a life as possible marks a success point in a busy profession. Sadly the procession of those in need is never-ending and physiotherapists, osteopaths, chiropractors and others could easily find themselves working from sun up to sun down in a bid to meet the ongoing demand.

Taking full advantage of time saving devices is one way to keep administration time down to a more manageable level. Electronic appointment booking, card payments, SMS text reminders, virtual assistant services; whatever the mix, finding ways to free up time will help busy health professionals to manage their day effectively. Who will win the Masters? We just don’t know but what we do know is that winning those everyday battles for fitness, fought by ordinary people of all ages, is for them every bit as important as any trophy could be.

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.

Healthy advice

Stories of sandbags and dredging may have captured the headlines but lurking beneath the disasters is a danger which if left unchecked could cause even more misery for thousands. That danger is the health implications of excessive rainfall.

On a day to day basis we don’t pay much attention to our waste. Yes, we wash our hands but in general we don’t stop to consider where our waste goes. We just assume that it is dealt with. But with flood waters pouring into drains and septic tanks, our waste is suddenly a lot closer than we’d like to believe and that can cause long term health problems for the unwary.

In recognition of this Public Health England (PHE) has issued some guidance on “the potential health impacts before, during and after a flood as well as advice and support on the response and recovery.” In addition to warnings about the dangers of sharp objects hiding beneath flood waters and advice on packing an emergency bag in case of evacuation the PHE advice also covers areas such as sanitation and food safety. The PHE advice also brings to the fore the psychological impacts of flooding which can cause symptoms such as tiredness, distress, anxiety and sleeping problems.

Whilst the NHS is generally the first port of call for those whose health and wellbeing has been affected by the floods, in the longer term other health professionals will be drawn in to the mix. Those such as counsellors and psychotherapists may be required to treat psychological traumas whilst physiotherapists, osteopaths and others look after people who have been injured whilst coping with the floodwaters. Even the simple advice to move precious objects upstairs is going to result in a fair amount of back and other strains for those who are unused to such exercise.

With so many affected, in some areas already overburdened health professionals are going to be put under further pressure. Finding ways to defer some of the day to day tasks such as telephone answering, diary management and the maintenance of patient records could help to deflect some of this pressure as well as maximising the time available for treatments. Whilst at least the flood waters bring with them warmer weather which reduces ice slips and strains this is cold comfort to those who require treatment from weather related ills. With the Government warning that things may get worse before they get better this is one story which sadly may run and run.

A ‘Wellcome’ cure

The Wellcome Library has opened up its archives of historical memorabilia for general use. According to the library the collection encompasses ‘manuscripts, paintings, etchings, early photography and advertisements’ and amounts to some 100,000 images.

Releasing the images under the Creative Commons Attribution Licence means that they can be used free of charge by anyone for personal or commercial purposes, provided that the image is accompanied by an acknowledgement as to source. So whether you are treating your patients for gout or for sprained limbs, for persistent pain or for an aching tooth there may well be a suitable image which you can use to amuse or to inform your patients.

In opening up the archive the Head of the Wellcome Library, Simon Chaplin, said “Together the collection amounts to a dizzying visual record of centuries of human culture, and our attempts to understand our bodies, minds and health through art and observation. As a strong supporter of open access, we want to make sure these images can be used and enjoyed by anyone without restriction.” The earliest image in the collection is a fragment of an Egyptian herbal, inscribed on papyrus. From that early beginning the collection encompasses medieval manuscripts, Victorian cartoons and some early photographs exploring the movement of the human body.

Providing effective patient treatments can be challenging at times and those working in the health profession know that keeping the tone light and adding touches of humour can help to alleviate patient anxiety. Access to an archive such as this can help to make the difference; although whether some of the images such as the Gilray cartoons portraying gout sufferers drinking port will teach us anything is a matter for debate.

But to be truly effective light heartedness needs to be tempered with professionalism and this is not always easy to achieve in a busy health practice. Answering the phone, finding or filing patient notes, sending out invoices and other administration tasks can all disrupt patient treatments. Outsourcing some of this work to a virtual assistant service can help to smooth over the working day and maximise time taken on treating patients. Virtual Assistant services can be taken on a permanent or ‘as required’ basis. This means that health practitioners can concentrate on what they do best, treating and reassuring patients, whilst being reassured themselves that behind the scenes day to day administration tasks such as phone answering, appointment reminders and invoicing are not being neglected.

Chinese Whispers

A GP who is at the forefront of patient engagement and empowerment has revealed that 99% of his communications with physiotherapists are still carried out on paper. According to the Chartered Society of Physiotherapy, Dr Amir Hannan said ‘I don’t think we use email as productively as we might or technology in general.’

With letters being used as the prime communication method, it can sometimes be weeks before the results of patient treatments are conveyed to the general practitioner, resulting in delays in considering appropriate follow up treatment. This affects the perception and actuality of patient care and can in some cases lead to a worsening of the patient’s condition.

In fact, Dr Amir highlighted the way in which delays in receipt of letters can result in the patient having to brief the doctor on the methods and results of treatments. Whilst this does play into the hands of those who advocate patients taking responsibility for their care, it also means that treatments and findings can be filtered with a ‘Chinese whisper’ effect resulting in distortions.

Dr Hannan’s comments were echoed by NHS England’s director of systems, strategy and technology, Beverley Bryant, who confessed herself to be amazed “how much paper flies around our hospitals”. As we have previously reported, one solution to this paper mountain is to adopt smarter practices which benefit from the use of current technology. The health care authorities are working towards this end but there are options available now for those who need to find a way to communicate more effectively.

One of the main barriers to swift communication is the simple lack of time available to those who want to maximise patient treatment time. Every time papers are filed, every time the phone is answered, every time an invoice is sent out is time which takes health practitioners away from their core task. Simply by using the services of a virtual assistant to take control of telephone answering, diary management, electronic records and invoicing enables practitioners to free up valuable time.

Working smarter, not harder may be a mantra which is parroted around the business-speak airwaves on a regular basis but it does carry an element of truth. Health practitioners took up the call to treat and improve the lives of others. By concentrating on that calling and leaving the day to day admin to others, everyone benefits.

Divide and conquer

A hospital in Derbyshire has been reaping the benefits of a new cleaning rota. Using an idea gleaned from overseas, the Royal Derby Hospital split its cleaning workforce into teams, each responsible for specific areas such as corridors or toilets. Previously a single cleaner had been responsible for an entire ward or area of the hospital.

The new system of team cleaning by area has lead to a reduction in cross-infections, traditionally a pre-cursor of the need to close wards for deep cleaning. In fact this new working pattern has been so successful that the hospital has been put forward for two Nursing times awards including the Golden Service award.

Hospital bosses have also found that by using teams rather than a succession of individuals, cleaning patterns are more flexible. This in turn has reduced the incidence of wasted cleaning processes, such as cleaning a patient area just before a patient is due to be discharged as well as ensuring teams are on hand in case an emergency clean is required.

The story is a perfect example of the way in which those at the forefront of health provision are finding ways to work smarter rather than harder. For example many health providers are looking to make savings by replacing follow up appointments with telephone calls or using the phone to make routine check-ups on those with ongoing problems.

It has to be acknowledged that telephone coaching is not universally successful if used in isolation as a study by UK researchers revealed earlier in August. They concluded that telephone coaching of those with long term conditions is not effective unless it is carried out as part of an integrated system of care.

Health professionals too are using this “divide and conquer” principle to maximise patient treatment time and minimise disruptions. Simply by outsourcing their phone answering to a virtual assistant service, health professionals can ensure that their phones will be answered, appointments made and reminders sent out whilst the health professional can concentrate on treating their patients. With no need to interrupt a treatment to answer the phone and no missed calls, professionals such as osteopaths, chiropractors and others can provide a more streamlined and efficient service to their patients.

The Olympic legacy – one year on

On 21^st July sporting stars joined 15,000 runners to commemorate the anniversary of London 2012. With 2,500 adults and children racing round a family friendly 1.5 mile track, the remainder of the runners tackled a 5 mile course which wound around the Queen Elizabeth Olympic Park.

The National Lottery anniversary run was started by Sir Chris Hoy whilst athletes such as Victoria Pendleton and Paula Radcliffe joined the mass runners cheered on by family and friends. Finishing on the Olympic athletics track itself every runner who completed the course created their own special memory to treasure and add to the host of positive memories of the Olympic and Paralympic games.

The run is not the only way in which the games are being remembered. As part of the legacy programme sports clubs across the UK have offered and continue to offer special taster days and extra coaching to tempt people to take up or return to sport. The ongoing success of these programmes can be seen with increased numbers of cyclists on our roads and a heightened level of competition enjoyed at many sporting events.

But the legacy is not just about competition and the true legacy can be seen in those who are enjoying sport as a means of keeping fit. Inevitably this results in an increase of sporting injuries as old joints and muscles are coaxed into working that little bit harder and those who once gaily set off on a run without any preparation discover the importance of stretching.

For physiotherapists, chiropractors, osteopaths and other health practitioners the sporting revival therefore carries the potential for an increased caseload. But in order to benefit from this legacy potential, health practitioners may have to optimise their working time. One option available is for activities such as diary management, client notes management and appointment reminder calls to be outsourced to a virtual assistant service. With phones diverted and day to day practice management outsourced, health professionals can concentrate on maximising patient treatment times.

The Queen Elizabeth Olympic Park is due to open its doors fully for business in the Spring of 2014. When it does it will offer many more opportunities to participate in sport. In the meantime there are lots of special events, taster sessions and trials taking place across the country for those whose appetite has been whetted for Rio 2016 and beyond or who just want to take up the challenge and get a little fitter.

The Wimbledon effect

If you are toying with the theory that everything and everyone are connected in some way then the annual feast of tennis at Wimbledon may help to cement your belief. For no sooner has the first ball been struck on the hallowed Centre Court than gardens and roads across the country resound with the thunk of old tennis ball on broken racket.

For two weeks every year it almost seems as though every child is a tennis player. Whilst the professional players may be contesting for pride and £millions, never has a match been more keenly contested than that staged in the alleyway between the garden shed and the cabbages.

Unfortunately, at the time of writing the first few days of Wimbledon 2013 have been dogged with controversy about the state of the courts and the numbers of those who have withdrawn due to injury. No matter that a higher number of players withdrew at the same stage of the US Open two years before or that the first couple of days always sees a number of slips at Wimbledon as the grass beds in; the toll of injuries has lead to much comment both in the press and in the players’ lounge.

In truth it is impossible for any sports person to go through their life without picking up one injury or another. Writing for the BBC, Andy Murray acknowledged this saying:

“As athletes, you spend a lot of your time carrying injuries of one sort or another. I’d say there are three categories: about 20% of the time your body feels great and you feel nothing; quite a bit of the time you’ll have something that might be a bit sore, but it doesn’t affect your tennis at all; the rest of the time you can be carrying something that means you have to compensate and make adjustments to your game. Everyone has to deal with it.”

Whether professional sports person or not, when an injury strikes the quicker treatment starts the better. Physiotherapists, osteopaths and other health professionals know that early treatment not only promotes a swifter return to form it can also help to prevent the occurrence of further compensating injures. But maximising the availability of treatment times is not easy when time is also taken up in managing diaries and answering calls. Using a virtual assistant service can relieve the pressure and enable health professionals to concentrate on helping patients to return to form without compromising on service.

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