By Kelly O’Brien, MD, FACP, CCHP
Posted on August 31, 2009 –
A recent article in the Annals of Internal Medicine demonstrates that patients who were connected with a specific physician were more likely to be receiving care consistent with national guidelines. I know it’s important for my patients to connect with me as a care provider, but this can be hard with our social disparity.
Attending the NCCHC Updates in Vegas earlier this year, I was given a special opportunity—an experience that let me be more connected to my patients.
For those of you who haven’t been on the Strip recently, the new hotels are beyond Over Consumption Self Indulgence. They’re each a world unto themselves. With a free afternoon for exploring, at 0.75 miles inside each hotel, I figured I could cover five hotels and get a good work out. As I took in the ambience, I wanted to run up to all the foreign visitors and explain that the rest of the country does not look or live like this. In fact, the rest of Las Vegas doesn’t look or live like this.
Deep inside the dark bowels of the hotels, panic set in a few times. I couldn’t find the actual exit-door-that-goes-outside. I had to tell myself, Calm down—no one’s been lost forever inside a hotel [but of course, if they were, how would we know?] There are no real exit signs because they don’t want you to really to exit. If you’re going to sit and rest, do it at a slot machine or a bar.
I inadvertently wandered by a box office, so I bought a ticket to a show for later. I purchased a take-out lunch at a pleasant little café and finally found my way back to the sunshine. The Bellagio Hotel has a lake in front with a huge fountain system that shoots out many spouts of water to literally dance in a cute animated way [considering it’s inanimate matter] accompanied by loud piped out musical numbers. This exciting visual/aural extravaganza was about to begin so I sat down on the overlook, tucked up under a large potted plant, in order to be out of the way, ready to enjoy my lunch while enjoying the Disney-esque spectacle.
The officer approaches on his bike. Ma’am [I hate that], I’ll have to ask you to refrain from doing that.
Doing what? Metabolizing? Respiration? We look at each other.
You want me to stop eating?
Yes, ma’am [again, I hate that.]
Where would you like me to eat?
I don’t know ma’am. [enough already] Are you a guest of the hotel?
I’m a guest of the Flamingo. I bought the lunch here. I show him the appropriately decorated bag, plastic testimony to my value as a guest.
You’ll have to take it off the grounds.
It’s an ahi salad. Surely this will prove that I can stay at the Bellagio to eat my Bellagio lunch. We lock eyes again.
You have to leave the property, ma’am. [dude] He settles in on the bike, now narrowing his eyes. He’s not leaving until I do.
I slowly gather my blazer, my lunch, my Coach bag, my little cup of water. It takes me a very long time. I make one last attempt to prove I’m worthy.
It’s pepper encrusted
You have to leave now, ma’am. [you are so doing that on purpose]
Well, who can blame this brave guard on his important mountain bike? A 50-year-old tourist, here with a medical conference, eating pepper-encrusted ahi salad in public, is a potential menace. Next thing you know, I might be not buying a t-shirt or discouraging someone from putting more money in the slots. Maybe I’ll skip a meal, or drink only one drink when I sit in the bar. I’m apparently the kind of hazard Vegas has trained its security personnel to root out immediately.
The guard follows me as I head toward the street- this takes a while, given the size of the grounds as well as balancing my box, cup and purse [note to criminals: purses slow you down.] Eventually he feels I am headed safely away from the Sacred Grounds of the Bellagio, so he can leave me to slink off in shame on my own. However, having been branded a trouble-maker, and wanting to see those dancing fountains, I do an immediate about-face, go directly to the rail and standing with my salad I watch the water show! Then, I gather my box and napkin and put them in the trash can, looking around for security cameras, so hoping they catch me on tape.
Now, when a patient tells me the police kicked him out of the park for no reason we connect. Yeah, I feel your pain, bud. I know about the Man. We can share a moment of silent suffering before I remind him that Vicodin is not a KOP med so don’t even ask.
1 Atlas, S., Grant, R., Barry, M. Patient-Physician Connectedness and Quality of Primary Care, Ann Intern Med. 2009; 150:325-335. This is so cool. Mine is the kind of writing that rarely gets to use references.
2 Estelle v. Gamble. I felt I had to throw this in. It seems most correctional care articles have this as a reference somewhere.
