Tuesday, December 27, 2011

"In The Beginning"

Creating a website with information regarding respectful care has been a long awaited goal. We all have visions and expectations as to the final outcome. Over the years we have all shared a wealth of information that seems invaluable, and what a gift it would be to share that wealth with those struggling for such knowledge.
Together we have helped people find the strength to overcome barriers and navigate the never ending mazes that healthcare often sends them through.
Now it's time to put those thoughts and words into a physical place: a virtual map of navigation together with the assurance that these seekers are not alone in the quest for understanding and knowledge.
This "construction site" will give everyone a clear vision of expectations...and when seeking volunteers and advice, it will be with a solid direction.

We have posted the original Mission Statement and Goals. All other comments have been deleted so that we can start fresh and view old ideas in new ways.

*Let's move forward!

*Let's start to build a foundation now, so that the goal is accomplished in just a short time.

A warm welcome to everyone.....



  1. Great start on the site. Here are two suggestions:

    1. There's a book called "Influencer: The Power to Change Anything" by Kerry Patterson and Joseph Grenny, et. al. I highly recommend it for those who want to read about successfully tested methods to bring about change.

    2. In the book you'll read about one technique called Positive Deviance. Here's how it works.
    -- Start with a problem you want to solve.
    -- Do some research to find out places that seem to be mostly free of the problem. Of course, this also requires discovering areas where the problem seems to be centered. In other words, where are the areas that deviate from the problem areas.
    -- Learn why the deviance. Find out what the areas lacking the problem are doing that areas experiencing the problem are not doing, or vice a versa.

    For us, this would require us knowing specific names of places (hospital and clinics) where people have had both excellent and poor experiences involving their modesty. We don't necessarily need to list caregiver names, but we do need to know the name of the place and the location. But the key is -- We need the good places, not just the bad places.
    Once we start collecting this data and get enough of it, perhaps we can persuade a graduate student in sociology to do a solid academic study that investigates how the cultures, policies, behaviors, salaries, hiring practices, etc. differ from one place to another.
    Doug Capra

  2. Doug that is one of the things that I thought would be of value, if we built a state by state guide that could provide information for people including experiences, ie I could post that Porter in Valparasio Indiana was receptive to a concern I had about providing opposite gender techs in imaging for intimate procedures and promised to institute changes in protocl to ask if there was a prefernce when scheduling. If I would post that and contact information it could provide a value to someone in that area. I used them instead of my local as they had male techs and my local only staffed females. We could also provide a simple excel grid with hospital/facility, contact info, and a list of patient friendly services such as same gender options for imaging, etc. One could request information from hospitals to populate the grid. It would accomplish a couple things provide information and put a little focus if not pressure on facilities to be aware of this that it is out there for people. The hard part on this would be gathering the information AND perhaps more, giving at least the impression that the site was viewed enough to have impact on them. The other thing I think would help is to have the site moderated and offer the option of the moderator contacting a facility-provider to ask some of the questions such as do you provide same gender provider for X, what accomodations could you make for a patient who..., etc. Given Hippa it would be difficult to address specific instances or name patients, it would have to be more general. There is also the possibility of taking concerns, we have a "subscriber" who visited your facility and had this concern. It would be my hope that these contacts would garner a little more attention from the provider for fear they would be widely viewed. Now if the site was successful beyond our vision, one might have to consider how to make it generate income for someone to staff, but that is a bridge to cross way down the road...thoughts? alan

  3. Here is a major element we should be looking for in hospitals and clinics:
    The whole issue of gender choice and modesty needs to be a topic that is out the open within these hospitals. It shouldn't be hidden, something that patients have to tip-toe through as they negotiate through the system. We should find references to the patient's right to gender choice of caregiver and modesty protection on these hospital websites, in pamphlets, and on documents that patients must sign before admission. It should be embedded in the hospital's philosophy of informed consent. Of course, the staffing and scheduling should reflect this and support it.
    We can start collecting pamphlets, websites, etc. We should ask hospitals how they deal with this issue. Is it out in the open? Unfortunately, I think we'll find few hospitals who follow this philosophy, that is, promoting it openly-- but we need to make sure we highlight these hospitals on this website. These hospitals represent the "good" in my suggestion about using Positive Deviance. This is where medicine is doing it right. We need to promote that. Let not only patients know about this, but let other hospitals know that it can be done and is being done and where it's being done.

  4. Good points Doug. Open, honest and (especially) accessible information is what will lead eventually to accountability. Modesty/respect should not be a footnote: it should be discussed as a viable concern when people are contemplating the possible “where and when” of procedures. Some people hold this part of the discussion until the end, many times unraveling the entire work put into the effort of patient expectation meetings. But if it really is a concern, let’s give people the courage and tools to bring it into the discussion as an important and practical need. Not a secret unspoken preference. Not a whispered inclination. A true and valid concern.
    With all of these things in mind, we wanted to discuss the need to parcel the publication of the website into segments of sorts. These should show a logical and hopeful progression. Perhaps at first the “top ten” we all feel we need to really put out there to make the most impact. Patient Bill of Rights (do most people know that insurance companies have these bill of rights also?) …downloads to take to the doctor to help focus and stay on target: in short, a wealth of information and support. Phase two could be the gender friendly facilities..those that have had positive responses and good patient experiences/ as well as the bad. Maybe phase three could be responses from the actual facilities wherein accountability would lay. I imagine compiling this data may take the longest time.
    Not set in stone, but a plan to get it out and running, while keeping the momentum of fluidity, growth, and the ever changing evolution of information.


  5. Another book I recommend to help us with this site is "Your Call Is (Not That) Important to Us: Customer Service and What It Reveals About Our World and Our Lives" by Emily Yellin.

    In the book's beginning, Yellin gives several examples how bad customer service stories can go "viral" these days. Savvy business know this and dedicate more resources to good customer service. It just takes one bad story, true or not, to ruin the reputation of a company. The other end of this is that good customer stories can go "viral" too. Hospital CEO's and managers are very sensitive to customer service these days.

    We need to make sure we don't threaten, or focus on the bad. We need to focus on the good, find where it's happening and give those hospitals, doctors, clinics some credit. That's the best way to influence the others to think about this issue and deal with it. Medicine has become a very competitive industry. We need to emphasize that good customer service in the area of patient dignity is good business.

    That's why we should emphasize our "good" list of facilities where modesty and caregiver consideration are working. For example, if there are three major hospitals in an urban area, and one of those hospitals gets on our "good" list, we should let the other two hospitals know that they are not on our "good" list and should be. Maybe the other two hospitals don't have the kinds of policies I listed in my post above. Maybe they just didn't answer our request for information. We don't have to say it, but the implication is that their competition is getting some great advertising by being on our good list.

    In other words, we don't have to emphasize the "bad." But by emphasizing the "good," we're giving an incentive for others to get on that good list.

    We might start with alan's Porter Health in Valparasio Indiana. Alan -- are you willing to tell the "good" part of the story and give them credit? We can write to them and ask about their policies in this area.

  6. I agree. I also think it would be good to share some positive outcomes from initially bad experiences. Such as (I believe it was Gail?) who had meetings and wrote letters, and was told that some protocals would be changed. That would also encourage people that there is a possibility of change in the system...they are more than just a silent wheel.

  7. I agree 100%, if this turns into another vent session we will not get the providers to partcipate. If we had a guide that provided info on what accomodations they would or would not make or have available. A simple excel with contact info, then the grid with columns such as gender choice sonogram, x-ray tech, or simply areas that can be accomodated along with comments. If we had tabs, what would would look like:
    Resources (
    Patient Friendly Hospitals by state
    Need and Advocate?

    While the site is a challenge, getting it out there will be even more challenging, so we all need to be thinking about that as we work on this. I agree though, we do not need the negativity that we see elsewhere...alan

  8. While searching the web on issues regarding patient modesty, I came across this site. I was encouraged by the goals you have set forth in your mission statement. I feel they are areas of great concern for many and will be very useful for all us in dealing with our own personal challenges and concerns when dealing with same gender medical issues. I look forward be being able to find helpful information and constructive dialog in the future. Any timeframe for when this might accure?

  9. annon Dec. 27 we really are just getting started in earnest, if you feel lead to partcipate we will be working on this, you might want to adopt a pusedo name so we can follow conversations,
    Suzy-Doug,I was thinking if we really want to make progress with any sort of speed we might want to consider using phone vs blogging, i think we could progress much quicking in sharing ideas and agreeing on a path. I am in the process of setting up an account with gotomeeting.com at my company which would allow us to conference in multiple people and view spreadsheets and power points. If we can gather email addresses I can send out the 866 dial in with the conference code and we can bring in 20+ people should we choose to. In this way we could target people interested in constructing a tool to deal with this vs just complaining and being negative....any thoughts...alan

  10. Thanx anon. for the encouraging words. I honestly had not considered that people may be coming here looking for solutions already. Perhaps we can make fast-work of phase one....and keep everyone posted on time frames.
    As alan said, feel free to tell us the issues that brought you here and solutions in your point of view.

    All the best to you in seeking respectful care...


  11. Thanx to all who voted. I wonder what (if anything) we can gleen from the 8/5 split?