Asset Management for Healthcare: March 2013

Asset Management in the Context of the Emergency Room

A discussion with Dr. Andre’s Creese is a natural follow up to Dr. Joe Ketcherside’s blog post, The Ultimate Goal of Healthcare. Fiscal and Physical Asset Management has much to do with context. That is, what circumstances brought you to acquire a particular asset? I thought about the greater context in which we operate. My discussion with Dr. Creese, an Emergency Room physician, continues that thread.

Dr. Creese is Board Certified in Emergency Medicine by the American Board of Emergency Medicine and a Fellow of the American College of Emergency Physicians. He has held positions of Medical Director, Chief of Emergency Medicine, Chairman of Emergency Medicine, and Assistant Professor of Emergency Medicine. In 2005, he appeared on the cover of U.S. News and World Report, Best Hospitals in the U.S.

"Dr. Creese is the CEO of OPYS Physician Services which provides Medical Leadership Consulting, Medical Consulting, and Physician Staffing. He is in active practice as well.

This blog isn’t so much as about the ultimate goal of healthcare. Rather, it focuses where governing policy and the payor mix collide with the street level needs of a human being. This happens in the most dynamic of ways in the Emergency Room.

I asked Dr. Creese about healing in this environment, “So, what does healing mean to you?”

His voice turned soulful. Yes, I heard confidence. Also, I heard possible connections. I heard history. I heard a story develop beyond my original intent as he answered my questions. But, it was fragmented.

He answered, “Relieving the patient’s condition as much as possible…. The healing part of an empathic provider is often missed. An empathic provider communicates a plan of treatment back to the patient and family with awareness of the impact.”

The connections came together when Dr. Creese mentioned how his path toward becoming a Medical Doctor developed, “It started when I was actually a teller at (a bank) in San Diego.”

“Can you talk about that a bit more?” I asked hesitantly.

He answered quickly. “I ran into a high school friend in my teller line. He said he was an ambulance driver and a lifeguard after just a 6 month two-day per week college course. Well, let me back up a minute.

“My dad was a New York City firefighter…. He fought fires in the years, when … you know, that was tough… because of his race…. My dad was always, always a good blue-collar, hands-on type of a guy. My mother had diabetes. I remember growing up. Many times, I would hear a commotion and wake up. My dad would run out. And my mother … would be… sick because her glucose is too low.”

I noticed Dr. Creese’s mid-sentence transition into present tense around this part of the conversation. “Seeing my dad with my mom …you know… mom would be half on the floor, slumped over and he is trying to get sugar in my mom… to get her to wake up, you know. Because, when your glucose drops low, you have, basically, minutes to fix someone otherwise… that’s it.

“I would like to think that’s where it came from… how my father would take care of my mother and help her.”

“So how did you end up as a teller?” By that time, Dr. Creese lived in California.

“I was really trying to find some way to go to college. I didn’t know how... I did swing manager at McDonalds. Just about every odds and end job, I even did construction work, trying to figure it all out. I remembered my dad always said, ‘get a fulltime job’. So that’s when I got a fulltime job as a bank teller.”

Okay. Now, play the banker teller reel to reveal a lesson in life altering moments. Dr. Creese’s friend sowed the seeds of a plan of treatment in the amount of time it took to conduct business at a bank teller window. Dr. Creese didn’t know a single doctor or nurse. Yet, the idea took root and he acted. The moment he stepped into the environment of pre-hospital medicine, he was “awestruck.” He got certified as an Emergency Medical Technician, EMT.

He responded to 911 calls as an EMT for 7 years. In that time, the idea still grew. One particular 911 call gave him a vision of how the matured idea could look.

“It’s dark… the road is winding… I’m on the phone talking to the doc… this guy is crashing in front of me.”

Visit Al Hardy’s Author Page on Amazon.

Read Part 2