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Episode 19: MedTalk with Dr. Scott Brasseur

This is the second episode in our MedTalk series where we interview professionals in the medical field both on the delivery side and the clinical side. Through these interviews, we hear more about their story, their field and how they are dealing with the shift to digital.

This time we talk with Dr. Scott Brasseur, an Internal Medicine Physician practicing at Spectrum Health. Dr. Brasseur shares his thoughts on the impact of technology on care delivery, an idea to improve the UX of healthcare technology and a story that fundamentally shifted how he views healthcare.

MedTalk is hosted by Aaron Shaver, Ph.D, OST’s Director of Healthcare and Life Sciences.

Enjoy!

Transcript

Aaron Shaver: Hey, everybody. On this episode of 10,000 Feet, Aaron Shaver of OST interviews Dr. Scott Brasseur, an internal medicine physician at Spectrum Health. This episode is the second in our Med Tech series where we talk with healthcare professionals to learn how technology impacts their working life. Enjoy.  

Aaron: So, you went to med school in the Caribbean? 

Dr. Scott Brasseur: Sure. Yes. 

Aaron: Tell me about that. That must have been pretty great.  

Dr. Scott: It was very good. It actually is an interesting way to — that I ended up there. First of all, back in the ‘80s, going to a foreign medical school was not really all that much of a problem. Whether you went to University of Michigan or Michigan State, or whether you went to Ireland or Mexico, it really did n’t make a bit of difference. And so, nobody was not going to tell me that I was not going to be a doctor. You know, I knew this when I was five years old and– 

Aaron: Okay. 

Dr. Scott: When they asked me if I wanted to be a fireman or a policeman or Superman or a doctor, it was always a doctor. And so, I went through undergraduate and I applied to medical school, and I got put on three alternate lists, three waiting list.  

Aaron: Okay.  

Dr. Scott: And while they never called, and as a med tech I could do a one-year internship, and that was by design. And so, I did it — I did my internship, and then I applied, and I got put on a couple more alternate lists. 

Aaron: Okay. 

Dr. Scott: So, I was right there. I was right at the cusp. And I said, “Screw it”, at the time. And so, I applied to some of the foreign medical schools and got into all of them, basically, from Ireland and–  

Aaron: The Caribbean sounds way better though.  

Dr. Scott: Oh, it does sound way better.  

Aaron: So, how long have you worked in Hastings?  

Dr. Scott: So, I moved to Hastings July weekend — July 4th weekend of 1991.  

Aaron: Okay.  

Dr. Scott: So, I am – somewhere between 25 and 30 years.  

Aaron: Okay.  

Dr. Scott: I keep on telling people 30 years, but– 

Aaron: So, you have seen a lot of changes in the relationship between independent providers. 

Dr. Scott: Oh, sure.  

Aaron: And health systems.  

Dr. Scott: Oh, sure.  

Aaron: You went — you did rounds in the hospital.  

Dr. Scott: Oh, sure. There was not a single point– 

Aaron: The lists from paper to EMRs.  

Dr. Scott: Oh, yes. All of it.  

Aaron: Yes.  

Dr. Scott: I lived through all of it.  

Aaron: Yes. 

Dr. Scott: There was not any still— 

Aaron: And you still have a lot of hair.  

Dr. Scott: I do.  

Aaron: Yes. So, you got pretty involved in implementing an EHR in your own practice, and then larger ambulatory space, and with the Spectrum and PANAC.  

Dr. Scott: Yes. I set up my own — my own IT system and server and dummy terminals, and things like this in my own practice, and then I helped PANAC. I was the — not sure what they called me, the physician leaders– 

Aaron: Physician champion.  

Dr. Scott: Something like that.  

Aaron: Yeah, you got to add the champion.  

Dr. Scott: Yes. Something like that.  

Aaron: It is important. 

Dr. Scott: That set up MEDITECH in the hospital for the very first time, and like any system that’s set up, there’s always a rough out-of-the-block start. And I guess the thing that I am proud of most is that the team that we were working with, once we went live, it was very rough for the first two, three, or four weeks, and there were lots of things to fix, lots of things to change right away, but we never had to shut down and start over.  

We — once we went live, we stayed live. And it has, you know, it has slowed a little bit, there were problems, but we fixed them on the run and they took off, and then of course they changed over to one of the other systems, I cannot remember of the top of my head.  

Aaron: Though you had eClinicalWorks when there is– 

Dr. Scott: Yes. That is right. They went from MEDITECH to eClinicalWorks– 

Aaron: eClinicalWorks to Epic–  

Dr. Scott: And at the Epic, right.  

Aaron: Yes. So, you have seen a few different– 

Dr. Scott: And then, I have I seen — Epic was the one that I slept in my office from — I had a dual server system.  

Aaron: You became like a quasi-IT guy, therefore I– 

Dr. Scott: I was. Yes. Absolutely. I mean, I hold myself out as one of the very few physicians that proudly say that, you know, I know IT until, of course, I run across someone like you, and I feel like– 

Aaron: No. 

Dr. Scott: I feel like a dork.  

Aaron: I do not know.  

Dr. Scott: When it comes to IT. 

Aaron: Yes. I think maybe we are all dorks here. So, tell me a little bit about — what inspired you to become a physician? You knew so early on.  

Dr. Scott: Yeah, I did.  

Aaron: Was there a life of that? Was it– 

Dr. Scott: Yes.  

Aaron: Was there? 

Dr. Scott: Yes. 

Aaron: Okay. Tell me about that.  

Dr. Scott: Yes. It was in one of the state parks in the state of Michigan. That is what we did for family vacations every summer. Dad and Mom took us to state parks and we had a 16-foot trailer, and we hauled it around, and we went from state park to state park every summer. And you know, you set up camp, and then there are other kids and other campgrounds and other neighbors and stuff.  

And so, we ended up getting to know our neighbors at the campground. And then, we would, you know, the kids were there, and we would play together, and we would go out to the beach together. And one afternoon, we all decided to go to the beach and their mom said, “Well, I think I might head back to the campground and clean up a little bit”. So, the kids stayed at the beach and my dad stayed at the beach, and my mom and this other lady started heading back to camp. And just a few minutes later, my mom started running back to us and saying, “Bob, Bob, Bob”, my dad. “Bob, come quick Mrs. so-and-so passed out”.  

And so, she was walking halfway back, and whether she had a heart attack or a stroke or even know whatnot — she just passed out. And so, of course, all the kids went running and we went running, and it was probably in this early ‘70s late ‘60s, probably late ;60s, and nobody really did anything. I mean nobody really knew CPR. Nobody really knew first-aid. Nobody really knew anything. My dad was a pharmacist, so he knew a little bit of first aid and–  

Aaron: Okay.  

Dr. Scott: He was one of the early ones to take on learning CPR, whatever that was at the time, and he volunteered on the ambulance a little bit because he was a pharmacist and he knew a little bit, so he thought, “Well, I will just help out”.  

Aaron: Yeah. 

Dr. Scott: And so, he tried his hand at CPR for the very first time, and we — of course, I was watching it, taking it all in. And a good half hour or 45 minutes later, dad’s still doing CPR, as effective or ineffective as it was, and the ambulance showed up, which was a bunch of volunteer guys.  

Aaron: Yes.  

Dr. Scott: And they basically had the attitude that, “Well, you know, she is gone”, and the kids started crying, everybody started crying, and they said, “Well, all right. Let us load her up”. And you know, I know now that they probably quit CPR a mile down the road, but– 

Aaron: Yeah. 

Dr. Scott: And I never heard her or found out whatever happened to her, but I am sure she died. And I just took that all in, and I said– 

Aaron: So, you felt kind of helpless as a kid and help like, I want —  

Dr. Scott: Oh, yeah— 

Aaron: I don’t want to be helpless.  

Dr. Scott: You know what, I told myself right then and there that that would never happen again. Not that somebody would not die ever again– 

Aaron: But it would not be because you were not prepared.  

Dr. Scott: It would not be because I was not going to try something. I do not care if it was putting a Band-Aid on their toe. I was going to do something– 

Aaron: Do something about it.  

Dr. Scott: Than stay in there. 

Aaron: Yes.  

Dr. Scott: And so, I went back and I, you know, talk — had my mom go through the first aid kit, showed me how to use it, and then I, you know, learned first aid, and then I was in Cub Scouts and Boy Scouts and got the first aid merit badges–  

Aaron: You have been doing this right along.  

Dr. Scott: Oh, all the way along, and then I just never quit. And then, I became an EMT, and then I volunteered on the ambulance, and then, you know, went to some paramedic classes, and then I did pre-med in college, and applied to medical school. I just– 

Aaron: This is like a whole continuum. It is not like you just became a doctor.  

Dr. Scott: No. 

Aaron: This is who you are.  

Dr. Scott: No. This is me — where I am at today is because of what happened to me when I was 5 years old.  

Aaron: So, let us talk about — so, we fast-forward.  

Dr. Scott: Sure.  

Aaron: We are here today. You have been through a lot of transition. You described quite a journey there, just from the time you were a little guy– 

Dr. Scott: Sure.  

Aaron: –having this experience-how are we doing caring for patients? You have seen this change in provider-patient relationship from the, you are my patient. I know your family. I know your parents. I know I went to your graduation whatever it is to the mergers and acquisitions of healthcare, the digital journey of the abstraction of the patient record, how has that changed your perspective on how we’re doing caring for patients?  

Dr. Scott: Yes. It is interesting how you say how we are doing and everything that you listed there was everything outside of what doctors do.  

Aaron: Yes.  

Dr. Scott: I mean, basically, everything that you mentioned, and you said how are we doing? I know what you are referring to, you are talking about the acquisitions in the hospitals and the IT, and the paper trail– 

Aaron: Has it made us better or worse?  

Dr. Scott: You know, I think– 

Aaron: Is it the same? 

Dr. Scott: You know, I don’t think it ‘s changed.  

Aaron: It is the same.  

Dr. Scott: It is — exactly. Because, see what healthcare is is just what happens inside the exam room.  

Aaron: Yes.  

Dr. Scott: Between a physician and a patient.  

Aaron: Yes.  

Dr. Scott: Now, whether that has to be in an exam room, or whether it can be over the Internet, or whether it can be over a, you know, a screen of some sort or a telephone call, that is likely to change. But it basically boils down to what the patient says to the doctor, and what the doctor says to the patient. And for the most part that really has not changed. I mean, through a lot of the things that I have been through, I have got to a point where I have just said, “You know, I am going to come in. I want a cup of coffee. Let me see my patients. I will write my notes, and then I am going to go home”.  

Aaron: Go home.  

Dr. Scott: I am going to go home now. Now, there is nothing in there, about acquisition or– 

Aaron: But being on the other side of it, right. I have been in corporate health care– 

Dr. Scott: Sure. 

Aaron: And technology for my whole career. Like, we have put a lot of effort into this.  

Dr. Scott: Sure 

Aaron: A little bit of an indictment– 

Dr. Scott: Sure. 

Aaron: And I am okay with that. That we have gone to all this expense, all this effort– 

Dr. Scott: Right.  

Aaron: But we have not really made a difference for you or patients.  

Dr. Scott: No. I do not think so. I mean, basically — well, it basically boils down to–to this day, even this morning, when I was at work, it boils down to me seeing patients in the exam room, and me writing the note to document that visit somehow, and going home. And whether you put a paper chart in front of me, or whether you put– 

Aaron: You can do that– 

Dr. Scott: IT computer in front of me, or whether you put a video screen in front of me, it basically boils down to that. As a matter of fact, when I first picked up the nurse that they have now, she says, “Well, how do you let me do this, and how do you want me to do that? And what do you want me to do when this happens?”. And we went through this whole thing. Basically the thing I had her walk away with is if I am not in the room talking to the patient, something is wrong.  

Now, I get how you have to take a blood pressure, and you have to take a pulse– 

Aaron: Sure. 

Dr. Scott: And you have to — I get how you have to do that, but beyond that, if I am not in the room, we are wasting time. And that is where one of my gripes is with the current system is that with IT, you can put so much information into a computer. I think people are trying to put everything into the computer. They want your depression history. They want your family history. They want all your vaccinations. They want they want everything. They want everything scored, and they track all these scores. They track all the — if you have high blood pressure, they want to know if I have repeated that blood pressure. And of course, unless I documented, I did not do it, apparently.  

And they track how often I repeat the blood pressure if it is elevated. Those are the numbers that they are looking at. They do not — tongue-in-cheek — they do not really care whether I actually take care of the blood pressure or not. They just simply want it documented that I noticed that it was elevated, and that I repeated the blood pressure and I documented the second reading.  

Aaron: Yes.

Dr. Scott: And it sucks, because that’s not patient care, that is just documenting patient-physician interaction. And so, when people like The Joint Commission come along or when other groups come along that pay for health care, they say, “Well, we are not going to give you any money unless we are sure that you have a quality healthcare system.” 

AaronYes.  

Dr. Scott: Well, what do we what can we show them? We cannot show them patient-physician interaction. All they can show them is documentation. And so, it seems like what a lot of this IT stuff has done is driven the documentation of the interaction as the more important thing now. They are hoping that you are going to take care of the patient, and that’s reflected in patient satisfaction scores.  

Aaron: To a agree. 

Dr. Scott: But you know, they’re chasing the documentation.  

Aaron: So, do you think that there’s a day — so, you talked about collecting a lot of data.  

Dr. Scott: Yes.  

Aaron: Collecting data is vastly different than delivering insights.  

Dr. Scott: Sure.  

Aaron: Right. There is — theoretically, we have seen it in other industries, the benefit to being able to harvest insights from large data sets at scale.  

Dr. Scott: Sure.  

Aaron: Do you think there is any clinical value, not just in research, not just in a dark room for administration, but at the point of care with a provider to say, “Hey, you have this unique situation. We’ve looked at the data set. Here’s a situation that has happened a hundred times over in the U.S. and other doctors.” Do you see a day that comes where we are able to derive point of care clinical insights from–? 

Dr. Scott: Sure. And I think we do that a little bit, but it’s just now catching on at least at the ground level, but that is — there is a term for it. I cannot remember off the top of my head right now, but up to date is publication– 

Aaron: Sure. 

Dr. Scott: that comes out, and you know, positive outcomes or outcome-based medicine, I think is the term I was looking for. Your, you know, outcome-based medicine. So, I know a number of Physicians that will say, “Gee, you know, I want to treat seizures and I would normally use Dilantin for it, and they go — they instantly doubt their own knowledge-base, and they go right to some type of– 

Aaron: A database. 

Dr. Scott: A database that says, you know, outcome-based medicine or outcome-based practice, and they look up the word seizure and they see that, “Oh, Tegretol is now the one that seems to work just a hair better than Dilantin, and they will order Tegretol. You know, which I guess there’s nothing wrong with, and so, that I think addresses what you were– 

Aaron: A little bit. 

Dr. Scott: Alluding to a — like at what point does point-of-care become affected by data collection? I guess that would be it. But I still rely 99.9% of my treatments based on my own experience, my own knowledge, ‘cause I got 30 years behind me now.  

Aaron: Yes. And not everybody has got that. You have some of the experiences.  

Dr. Scott: I work with a few of them too, and they are always asking questions which is wonderful, but they could always search out the same answer on something like UpToDate or something like this, which is apparently always changing.   

Aaron: Yes. All right. Well, let’s talk a little bit — so, you have talked a little bit about what you have disliked about it, what you liked about it, how it’s impacted clinical care. Let’s switch to a little bit more personal subject. So, tell us a little bit about an experience that you’ve had in healthcare that impacted a family member, you talked a little bit about as a kid.  

Dr. Scott: So, I think you’re alluding to the — my life changing event recently, and that is December of 2014. I was on my way to work. I always like to say, minding my own business.  

Aaron: Yes. You never do that. I know better than that.  

Dr. Scott: Which all my friends do not listen to us are going, “Wait a second. That’s not him”. And I had this excruciating pain and people that say that they have been through childbirth, or people say that they have had a kidney stone, you know, talk about this excruciating pain. And although, I have had kidney stones, this was like a factor of, you know, 200 higher than– 

Aaron: This is the 10 out of 10.  

Dr. Scott: This is like 15 out of 10.  

Aaron: 15 out of ten. 

Dr. Scott: This is the 10 out of 10 because nobody could imagine that there is anything– 

Aaron: You did not know. Yes. Okay. 

Dr. Scott: But nobody knows that there is more intense– 

Aaron: So, inconceivable. 

Dr. Scott: It was easily higher than a ten. And it took my breath away. I became dizzy. And I, you know, the first thing I thought of is that I was having a heart attack. Of course, my clinical mind kicked in, and I started going through the– 

Aaron: You start diagnosing yourself.  

Dr. Scott: I start diagnosing myself. I started going through — I am so — well, wait a second. I am not sweaty. I am not this. I am not that. And so, I do not think it is a heart attack, and then I thought, “Oh, you know, I felt like something was ripping”. And so — and then I thought, okay. Well, it is an esophageal varix. And I thought, well, wait a second. It cannot be an esophageal varix. I am not bleeding, you know, so that is not it. I am not choking, so that is not it.  

And then I just thought, oh my gosh. I said, I bet you I am dissecting my aorta and which my very next thought, quite honestly, was then I’m dead. You know, I mean I’m easily dead. And I recall my very next thought after that was — is that while I am driving a car, and it is early in the morning, and if I pass out and die, I am going to go through someone’s front room. So, I thought, literally, I better pull over, so I don’t hurt anybody else.  

Aaron: Yes. 

Dr. Scott: And– 

Aaron: And this probably all happened in a split second. 

Dr. Scott: Oh, yes. Right. Yes. This all happened within, you know, two turns the wheel.  

Aaron: Okay.  

Dr. Scott: I am going down the road at 25 miles an hour, but surprisingly in retrospect, I was not scared at what — I mean, I knew I was going to die. I recall thinking to myself; this is it. There were no ifs, ands, or buts, about it. I knew I was gone. But there was not a panic like, “Oh, my gosh. I am going to die”. It was just, “Hey, this my time”.  

Aaron: Here it is. 

Dr. Scott: Here it is. It was — there was no panic. There was no anxiety. There was no frustration. There was no — there was no, “Oh, I should have–“. It was just, “Hey”.  

Aaron: So, I got to ask the question, and I am sure everybody wants to know.  

Dr. Scott: Sure.  

Aaron: You just said that you felt your aorta dissect, you could feel it. 

Dr. Scott: Yeah. It was just a very ripping sensation. So, I pulled over preparing to just pass out, and then a good few seconds after that, I didn’t pass out, and the dizziness kind of went away a little bit. And at that point, clearly, the dissection had stopped. And so, the pain stopped. Of course, all the damage was done at that point, needless to say. And I don’t really know how much time I had left. But I thought, well, am I going to stay here — I could actually, literally, visually, see the hospital from where I was parked.  

And so, I thought, “Well if it is going to ease up a little bit, I am going to drive to the hospital”. And that is when things started getting weird because I went to the hospital knowing that I probably dissected my aorta, and I walked up to my office.  

Aaron: What? Which is like on the third floor– 

Dr. Scott: Which is on the third floor.  

Aaron: Yes. Okay.  

Dr. Scott: And I was dizzy. And I thought to myself, “Well, I better hurry up and get to my office, so I could sit down”, you know. But at the same time and not a part of me was saying, “Well, you are going to die”. And I thought, “Well, I cannot die in the hallway”. I mean, someone will– 

Aaron: Make it to your office. 

Dr. Scott: Trip over me. You think weird thoughts, I guess.  

Aaron: Okay.  

Dr. Scott: And so, the first thing I did was call my personal physician, who I knew was more than likely driving in at the moment, because it was about six in the morning, or so. And so, I called him. I said, “Hey, look I really feel awful. I need to see you in the office today”. And he said, “Where are you at?”. I said, “Well, I am in the office”. And then he goes, “Okay. I will be right there. Don’t move”. And of course, the story that he tells now is that, you know, I never miss work, and I never ask for help, but I never make it a doctor’s appointment, you know. And here I have got this guy calling me who is, at the moment, the political director of the Intensive Care Unit, and probably the Chief of Medicine, you know, asking me for help.  

Aaron: Are you going to give the guy a shout-out on your podcast for–? 

Dr. Scott: Oh, it is Dr. Smendik.  

Aaron: Their you — okay. Doug Smendik. All right.  

Dr. Scott: He is an amazing doctor.  

Aaron: Isn’t he? Indeed. Yes. 

Dr. Scott: As long as he keeps referring to me as his go-to guy for answers, he is an amazing doctor.  

Aaron: Okay.  

Dr. Scott: Our last visit, he was talking to me about the perils of high blood pressure. Yes. So he goes, “This awfully awkward talking to an internist about the perils of high blood pressure” — but nonetheless — he says, “Just stay right there”. And so, I did. And he comes on in, and of course the door is locked, and he had to find maintenance, and gets the maintenance in, and he finally finds me. So, somehow I made it down to the intensity, or to the ER, and Dr. Amy Poholski, and I am– 

Aaron: Oh, yes. That is good.  

Dr. Scott: While I was down there. And they heard what I had to say, and they got a quick EKG, which was perfectly normal. And then, they got a CT scan, the CT scan apparently showed the dissection, and the dissection went for my aortic valve all the way down to my legs– 

Aaron: But then inches to us nonclinical people.  

Dr. Scott: The whole length of my body. It went my heart to my groin.  

Aaron: Wow. Okay.  

Dr. Scott: You know. So, it went from the aortic valve, which was the inside of the heart and it ripped all the way down around the arch, all the way down past my diaphragm, past my kidneys, all the way into my legs. It dissected some of the kidney arteries and some of the splitnix which are the blood vessels that supply the intestines, and so they are all split open. And you know, for the most part, I was, you know, it was just a matter of time before I had died.  

Aaron: Yes.  

Dr. Scott: And it really was.  

Aaron: Yes.  

Dr. Scott: And so, she — Amy told me about the dissection and she says in luck, you know, we are going to get you off to Grand Rapids, and we are going to get you on a helicopter because it is just that urgent, and I knew it was. But then, the weather was too bad to fly. So, they threw me in the back of an ambulance– 

Aaron: And you know about that too because you are a pilot, as well.  

Dr. Scott: I am a pilot. Yes. And so, they threw me in the back of an ambulance, and we went red light and siren all the way up to Grand Rapids, and I was in the emergency room there and they were ready for me. They had multiple doctors, multiple nurses, a couple of surgeons already to go.  

Aaron: Were you conscious at this–? 

Dr. Scott: I was. Yes. Absolutely, packed — packed room. And you know, later ona number of them confided in me saying, you know, they knew I was dead, but I wasn’t dead yet, so let us move them up the Grand Rapids. Well, once I got to Grand Rapids it was like, okay. Well, he is going to die, but let us make the effort to at least take him to the operating room.  

Aaron: Yes.  

Dr. Scott: Once I got to the operating room, it is like, “Okay. Well, he is going to die on the table, but we better at least try to get started”. Well, right, that just kept going.  

Aaron: Kept going. Nobody wanted to stop.  

Dr. Scott: Nobody wanted to stop, but they all knew that I was going to die during their procedure.  

Aaron: Yes.  

Dr. Scott: And it just never happened. And I ended up going back into surgery for cardiac tamponade, which is fluid around the heart, because it was still bleeding. And again, it had just about stopped, and then they had to go back in surgically and drain the sac around my heart. And apparently, I was defibrillated a couple of times, and of course, I was unconscious during all that, but — and I woke up. And the next thing I remember was my family at the foot of my bed and they were all smiling. They were all exuberantly happy, and to me it was just like, “Look, I feel awful just — what are you guys so happy about?”.  

Aaron: Yes. Because everybody is smiling about– 

Dr. Scott: Yes. And because I just woke up, and as far as I was concerned, it was the next morning. And I find out later that was a month later. It was two or three weeks later. 

Aaron: Yes. 

Dr. Scott: And so, then I started learning the back story of what happened. And so, yes. I think my attitude has changed. I mean, before I was invincible and I was in charge, I was the director, I was the Chief. I was the one — I was the go-to person and prided myself on, you know, constantly studying, so I could help other people. And it just all became unimportant after that.  

Aaron: Has Healthcare become more personal for you after this? 

Dr. Scott: Absolutely. Before, it was tasks. Before, it was consults. Other doctors would consult, the internist doctors, whether it be myself, or one of the other partners, and to help them with their tasks. And they were just basically a series of tasks to solve. A series of problems to solve. 

Aaron: You see the people more now. 

Dr. Scott: Oh, I see. That is nothing, but I see it. As a matter of fact, one of my patients awhile back asked me, you know, if and when I was going to retire. And I told them I was already retired. I am retired right now, and what that basically means to me is that, you know, I am no longer that doctor that comes in, solves problems and tasks and medical disease. I basically come in have my coffee, and I visit with about 15 friends and, “Hey, check this out. I went to medical school”. So, if you want to throw a medical question at me, you know, I’ll take a swing at it.  

Aaron: So, life perspective, better before or after? 

Dr. Scott: Oh, it is emotionally much better now. But I was built for the life before.  

Aaron: Got ya. 

Dr. Scott: You know, I loved it. I would easily — I don’t want to say I will easily go back into intensive care, but I miss intensive care, I miss the hospital patient, I miss coming in and having nobody know me, and people look at me like, “Oh, my gosh, you know, this is the guy that they have been talking about during — this is the guy that is going to help us in the Intensive Care Unit”.  

Aaron: Yes. 

Dr. Scott: And maybe put someone on a ventilator and get them through something that they weren’t expected to get through. And that is a wonderful feeling; it is very addictive. But you know, after my heart blew up– 

Aaron: Yes. 

Dr. Scott: You know, I’ve started taking the backseat. But I truly see people as people and they have got a lot of other problems other than the medical problem that they are bringing me, and I try to dig those out of them as I try to you know, walk through their problem with them.  

Aaron: Okay. So, I appreciate you sharing that. It’s a very personal story.  

Dr. Scott: Sure. 

Aaron: I am going to ask you a couple — like rapid fire questions here. You don’t have to you know; you can give us a little call around. 

Dr. Scott: Okay.   

Aaron: Let’s talk about technology.  

Dr. Scott: Okay.  

Aaron: Given that perspective– 

Dr. Scott: Yes. 

Aaron: If you could — you had a magic wand. I do not even care how you solve the problem. We do not have to worry about how the technology works.  

Dr. Scott: Sure.  

Aaron: But if you could solve a problem in health care today, what would it be? 

Dr. Scott: In health care? 

Aaron: Yes. 

Dr. Scott: I will tell you what’s one of the more frustrating things that I deal with in healthcare, but it’s — it’s at home right now as well too. And that is the interaction between hardware and software. It’s very frustrating when I go to print something, and the printer is not hooked up or not working right. Or I go to click on a button that takes me to another screen and it just sits there and looks at me, and nothing happens. Or I am behind on — in my day. I got busy with somebody, so I am behind, and I have got to write a bunch of prescriptions, and then the patient says, “Oh, I have got one more thing. Could you order this for me?”.  

Aaron: Yeah. 

Dr. Scott: I’m thinking, okay. Sure. Fine. I’d be glad to do that. And so, I click a button to go back to the order page and it just stares at me for a while.  

Aaron: So, you know, like technology that stares at you. 

Dr. Scott: I mean, I wish — you know what I wish I had? I wish I had a magic wand that gave me five times the megahertz clock speed that I currently have– 

Aaron: Okay. 

Dr. Scott: Plus, five times more chips, and maybe a terabyte– 

Aaron: Just make it faster.  

Dr. Scott: A terabyte of RAM.  

Aaron: And now, you are getting into the technology.  

Dr. Scott: Yes. Well, but that is what I want.  

Aaron: You want it to go fast.  

Dr. Scott: I just want what I want, when I want, how I want it. If I want to know your med list. I want announced.  

Aaron: I want announced. Right now. 

Dr. Scott: And when I want to go to the order page, I want to be at the order page. When I want to know your family history, I want to be at the family history page.  

Aaron: All right. Next question. If you have a platform here, a lot of technology people listen to it, as a clinician, what message do you want to send to technology professionals? What would you tell them?  

Dr. Scott: Doctors are interested in their patient.  

Aaron: Okay.  

Dr. Scott: Doctors are not interested in fancy computer screens and things like this. They need to use that in order to access information to help their patient. But whether it’s a computer screen, or whether it’s a touchscreen, or whether it’s a mouse, or whatever else, just remember that the doctor is worrying about is their patient and technology typically, slows us down. Whether it’s because something is not working right, or something needs to be rebooted, or — and this is the craziest thing — why — so, I do not really know.  

But imagine, like these updates. These updates are horrendous. Granted, software needs to be updated. But imagine being in a car. Imagine being in a car going down a highway and you stop and get something to eat at McDonald’s, and you get back to your car and the headlight buttons’ been moved. 

Aaron: Or it is like, “Sorry. You cannot drive it right now. It is updating”.  

Dr. Scott: It is updating, come on. Or imagine the blinkers being in the wrong spot. Or imagine it going from a manual or an automatic transmission to a manual transmission. Or imagine the whole interior being a different color.  

Aaron: Okay.  

Dr. Scott: Or something like this. Or the speedometer goes speed limit thing going from an analog to a digital, or back to analog– 

Aaron: Or it is miles and it was kilometers, or whatever.  

Dr. Scott: And not that you cannot get used to it, and not that they have not proven that the way they changed it– 

Aaron: But you lose the muscle memory you had.  

Dr. Scott: Oh, you know what, I was going to bring that up.  

Aaron: Yes. 

Dr. Scott: The muscle memory — you lose it.  

Aaron: And your efficiency goes down.  

Dr. Scott: And the efficiency goes down, and then you end up saying to yourself, “Okay. Well, I need to write this new prescription, you know, where is the order page again?”. The order page used to be right here, now; it is not there anymore.  

Aaron: Yes.  

Dr. Scott: So, you spend two or three minutes looking for– 

Aaron: So, less is more. That is what you are saying.  

Dr. Scott: Less is more. 

Aaron: Less is more. Okay.  

Dr. Scott: I wish dealing with a computer screen, there were certain basic things, that regardless of the update, always stayed the same in the same spot.  

Aaron: So, let me — this brings an analogy to mind.  

Dr. Scott: Okay. 

Aaron: To my mind. You’re a pilot; I’m a pilot.  

Dr. Scott: Sure.  

Aaron: I do not know, was it the mid-60s, mid-70s? They developed the standard configuration pilots for a six-pack gauge.  

Dr. Scott: Sure. 

Aaron: Right.  

Dr. Scott: I know exactly what you are talking about.  

Aaron: And when you are an instrument pilot, you learn your instrument scan.  

Dr. Scott: Right. 

Aaron: Right. 

Dr. Scott: Muscle memory of your eyeballs.  

Aaron: Muscle memory of your eyes, you do this instrument scan, and to those who aren’t pilots, if you do not have a good instrument scan, you are dead.  

Dr. Scott: Right. Now move those instruments. 

Aaron: So, prior to this standardization, and I think it was the mid ‘60s, maybe late ‘60s– 

Dr. Scott: Right.  

Aaron: They could have any configuration anywhere, and you’d have to look all over the place.  

Dr. Scott: Right.  

Aaron: Standardizing the configuration saved a lot of lives.  

Dr. ScottRight. 

Aaron: You think of it as an that. Like, can we not have a standard instrument– 

Dr. Scott: Perfect. Okay. Absolutely, perfect. That maybe if I had one computer software company, and you had a different computer software company– 

Aaron: That is my problem. Yes.  

Dr. Scott: But the standard layout is going to be the same.  

Aaron: Imagine that.  

Dr. Scott: So– 

Aaron: So, you scan where you find things. Yes, okay.  

Dr. Scott: So, like right now, as I think of the software that I use right now, I have to stop and think. Okay. What do I want? And then, where did they put that? And I have to think to myself where’d they put that, or where is it likely to be. Now, of course, if it is something simple like, I want to know what medicine they are on, I can go to their medicine page. But oftentimes, getting to their medicine pages is still a couple clicks away.  

Aaron: Yes.  

Dr. Scott: And maybe a scan, you know, it is — you are on the right page, but you do not see it. You have to scan to it.  

Aaron: Yes.  

Dr. Scott: You know, you have to scroll to it. Maybe, I guess would be the right word, and that is frustrating. So, if we had like a– 

Aaron: We need the six-pack of information–  

Dr. Scott: Well, yes. We do. We need something across the top of the screen–  

Aaron: Like, maybe we just came up with an idea– 

Dr. Scott: We just — we need something across the very top of the screen– 

Aaron: Standardized in all– 

Dr. Scott: That says family history, social history, medications, allergies, or you can combine them, like meds and allergies together, family history, social history, together. Past medical history, past surgical history, together. Yes. You can combine– 

Aaron: Somehow standardize it. 

Dr. Scott: But put them up at the very top, so that at the moment’s notice, if you are talking, and you say something like, “Oh, yes. Every time I get short of breath, my hands all cramped up”, you know.  

Aaron: So, it is right there.  

Dr. Scott: Yes. So, I go up to family history, I just click it. And then, instantly I am at family history, I can look back to see what is listed there, and then I can click on something else, and go to something else. But you know, there needs to be some upgrades definitely, but upgrade the inside pages. Do not upgrade the standard six-pack.  

Aaron: Yes. The six-pack–  

Dr. Scott: The six-pack in medicine.  

Aaron: I like that, the six-pack in medicine. Okay. Good idea. All right. We are going to end with one question here.  

Dr. Scott: Okay.  

Aaron: Personal recommendation to our listeners, could be a place to travel, a book to read, food to eat, a workout routine, meditation, whatever, recommend something to our podcast listeners that they can take away and try for themselves that you have found meaningful.  

Dr. Scott: And this is coming from the bottom of my heart. Everyone needs to try a random act of kindness.  

Aaron: Okay.  

Dr. Scott: A random act of kindness. It has to be done in a way where you actually pursue it. You actually look or it. You actually scan the public around you. You actually scan the people in the grocery store. You actually scan the people that are around you, and you look for people that need help.  

Aaron: Yes.  

Dr. Scott: And you deliberately reach out to them, and you deliberately do something that there is no way in — there is no way that they could ever repay you. And that could be very small. It does not need to be expensive, does not need to be money. It does not need to be anything. You know, that might be money, but it does not need to be — you just — and you get addicted to that.  

Aaron: Yes.  

Dr. Scott: You can absolutely get addicted to that. To correlate to that is, you know, is to set up some site, some type of pay-it-forward system.  

Aaron: Good. 

Dr. Scott: You know, either do something, and when someone just insist on, you know, paying you back, or here, let me give you that — no. I do not want it. 

Aaron: Just don’t. No strings attached. 

Dr. Scott: Don’t make this difficult. It’s a gift. Pay it forward. If you need — if your soul — if your heart needs to pay me off, pay it forward.  

Aaron: Yes.  

Dr. Scott: So, random act of kindness.  

Aaron: All right.  

Dr. Scott: You got to get addicted to that.  

Aaron: What an appropriate message for the holiday season. 

Dr. Scott: Here you go. Well, yes. And so, many people think about that along the holiday season, but it’s fun to do it in the middle of March too. 

Aaron: Absolutely. All right. Well, Dr. Scott Brasseur. Thanks for being on with us.  

Dr. Scott: Wonderful. Thanks for having me.  

Aaron: Yes. Absolutely. Great.  

Lizzie Williams: OST changing how the world connects together. For more information go to ostusa.com/podcast. 

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