Great article David, it really opens up an intriguing conversation about how we can reimagine healthcare environments to better support healing and well-being. It's interesting to think about hospitals not just as places where medical issues are addressed but as spaces where every aspect of patient care is designed to promote health. I'm curious, though, about how these ideas could be implemented in the real world. It seems like there would be significant challenges, especially in terms of funding, infrastructure, and changing longstanding institutional habits and cultures. But the potential benefits for patient recovery, staff well-being, and overall healthcare outcomes seem well worth exploring these challenges.
What do you think? Do you see any of these changes being easier to implement than others, or do you think there's a particular area that could serve as a starting point for broader transformations in healthcare settings?
I think you've nailed it. Changing the mentality or as you put it the institutional culture and habits its the hardest thing and will take the longest. I'd wager certain aspects could quite easily been achieved and if we use the right tool and timeline for evaluation we may even see a cost reduction (I am thinking specifically some of the exercise stuff but I am not convinced the rest would be different).
I think exercise is the easiest starting point - arm ergometers are not super costly and I think if we were to look at outcomes including function upon return home, medication use etc we'd see a net saving in the medium term. But we need to convince people to do the work to prove this unfortunately. Someone once said: "in God we trust, everyone else must present data" and here we are.
Great article as usual David. I really enjoyed this fascinating insight into the medical system. I have ‘trained’ (as opposed to exercised) and been into health and nutrition since a young teenager and at 49 suffered an MI with no risk factors other than very high LDL-C. I was not offered any ‘Cardiac Rehab’ (even after ringing up and leaving a message nobody got back to me). The day I got out of hospital (after four days of poor nutrition) I started the journey back by walking for an hour or so and within the week easing back into my resistance training. I have a background in the fitness industry and was confident I could use my knowledge, experience and commonsense to slowly progress back to where I was. This only took me a couple of months. My point is, exercise may have saved my life in the first place, then helped me physically and mentally get back on track in a very short timeframe. This is one area that clearly needs improving so the ‘average’ person can recover via the full and varied benefits of exercise that is carefully managed and progressed by trained professionals. 3 years later at 52, I am fitter than ever and nearly as strong as in my twenties (no re-MI touch wood). Bye the way I love: "in God we trust, everyone else must present data"
Thank you. I am sorry to hear about you MI and experience in general. I am surprised you didn't receive any cardiac rehab but I also think the system isn't quite as good at managing more atypical cases at times - I'd suggest even post MI your capacity was better than most who are post cardiac rehab given your age and background.
I do think we don't do enough with exercise in the healthcare system - I worked on a few projects as a medical student to try and resolve this (at least in Australia and Europe) though it is very hard to create change in such a big and archaic system.
Glad you liked the quote - certainly not mine but stuck well!
Thanks for the reply David, they are very relevant points you make, my capacity was definitely better than most and being an atypical case could have been a reason for the lack of follow up. On a side note, Tim O'Donnell had a heart attack the same day as me (he is much younger of course) and he went through the cardiac rehab. Even us outliers deserve the same level of care.
I don't disagree that everyone deserves personalised care - let alone the same level my thoughts were HOW may you not have received this and why not. Tim is an interesting case, I wonder if you fell into "no man's land" so to speak between deconditioned and professional. It wouldn't surprise me. I certainly helped a friend recently advocate for themselves as they were a professional athlete - I think this makes sense but also leaves those of us who are perhaps better described as "avid amateurs" frustrated and underserved compared to the sedentary or professional.
That is so true, a great insight and 3 years post-MI it makes me feel better to hear someone acknowledge this 'no mans land' void. The health and performance community are far better for your presence, keep up the good work!
Great article David, it really opens up an intriguing conversation about how we can reimagine healthcare environments to better support healing and well-being. It's interesting to think about hospitals not just as places where medical issues are addressed but as spaces where every aspect of patient care is designed to promote health. I'm curious, though, about how these ideas could be implemented in the real world. It seems like there would be significant challenges, especially in terms of funding, infrastructure, and changing longstanding institutional habits and cultures. But the potential benefits for patient recovery, staff well-being, and overall healthcare outcomes seem well worth exploring these challenges.
What do you think? Do you see any of these changes being easier to implement than others, or do you think there's a particular area that could serve as a starting point for broader transformations in healthcare settings?
I think you've nailed it. Changing the mentality or as you put it the institutional culture and habits its the hardest thing and will take the longest. I'd wager certain aspects could quite easily been achieved and if we use the right tool and timeline for evaluation we may even see a cost reduction (I am thinking specifically some of the exercise stuff but I am not convinced the rest would be different).
I think exercise is the easiest starting point - arm ergometers are not super costly and I think if we were to look at outcomes including function upon return home, medication use etc we'd see a net saving in the medium term. But we need to convince people to do the work to prove this unfortunately. Someone once said: "in God we trust, everyone else must present data" and here we are.
Great article as usual David. I really enjoyed this fascinating insight into the medical system. I have ‘trained’ (as opposed to exercised) and been into health and nutrition since a young teenager and at 49 suffered an MI with no risk factors other than very high LDL-C. I was not offered any ‘Cardiac Rehab’ (even after ringing up and leaving a message nobody got back to me). The day I got out of hospital (after four days of poor nutrition) I started the journey back by walking for an hour or so and within the week easing back into my resistance training. I have a background in the fitness industry and was confident I could use my knowledge, experience and commonsense to slowly progress back to where I was. This only took me a couple of months. My point is, exercise may have saved my life in the first place, then helped me physically and mentally get back on track in a very short timeframe. This is one area that clearly needs improving so the ‘average’ person can recover via the full and varied benefits of exercise that is carefully managed and progressed by trained professionals. 3 years later at 52, I am fitter than ever and nearly as strong as in my twenties (no re-MI touch wood). Bye the way I love: "in God we trust, everyone else must present data"
Hi Damian,
Thank you. I am sorry to hear about you MI and experience in general. I am surprised you didn't receive any cardiac rehab but I also think the system isn't quite as good at managing more atypical cases at times - I'd suggest even post MI your capacity was better than most who are post cardiac rehab given your age and background.
I do think we don't do enough with exercise in the healthcare system - I worked on a few projects as a medical student to try and resolve this (at least in Australia and Europe) though it is very hard to create change in such a big and archaic system.
Glad you liked the quote - certainly not mine but stuck well!
Thanks for the reply David, they are very relevant points you make, my capacity was definitely better than most and being an atypical case could have been a reason for the lack of follow up. On a side note, Tim O'Donnell had a heart attack the same day as me (he is much younger of course) and he went through the cardiac rehab. Even us outliers deserve the same level of care.
Looking forward to your next post :D
I don't disagree that everyone deserves personalised care - let alone the same level my thoughts were HOW may you not have received this and why not. Tim is an interesting case, I wonder if you fell into "no man's land" so to speak between deconditioned and professional. It wouldn't surprise me. I certainly helped a friend recently advocate for themselves as they were a professional athlete - I think this makes sense but also leaves those of us who are perhaps better described as "avid amateurs" frustrated and underserved compared to the sedentary or professional.
That is so true, a great insight and 3 years post-MI it makes me feel better to hear someone acknowledge this 'no mans land' void. The health and performance community are far better for your presence, keep up the good work!
Appreciate the kind words Damian. Glad you're enjoying the writing and are thriving 3 years on