I've been inspired these past two weeks by an organization that has nothing to do with IT. My wife has been suffering from swelling eye muscles as a result of Graves disease, a thyroid condition, and probably complicated by pregnancy. The eye muscle swelling had caused her eyes to push forward putting considerable strain on the optic nerve resulting in double vision/loss of color vision in one eye. Our eye specialist, Dr Nowinski is affiliated with Wills Eye Hospital in Philadelphia. As conditions got worse, Dr Nowinski escalated the issue to Dr. Sergott of Wills who is Co-Director of Neuro-Opthamology. Dr. Nowinski knew that it was important to act before the condition became irreversible.
What impressed me about Dr. Sergott was that he was treated and respected for the position he held and the amount of experience he carries. Almost all of the other functions that other people could do were given to support staff leaving him to focus his energy on double checking his resident's test results and making the tough decisions.
Wills Eye is considered one of the best eye hospitals in the country. You don't get that way by doing things ass-backwards. Dr. Sergott runs what would say is a 'tight ship'. I wanted to describe things in this blog about how the operation worked because I thought it was so extraordinary to see. It was like computer made up of humans.
The waiting room served as a process holder. The reason I say this is because we were in and out of the waiting room several times. We would go into one of the examination room (1 of 5 in the banks) only when they could do something of value with us (eye test,etc) and then we would wait in the waiting room until they could execute the next step in their workflow. There was a gentlemen who was there mostly to direct traffic and to escort people through the narrow hallways to the proper room. I believe he had other office work to do but examination room logistics seemed to be his main responsibility.
When we got in, a resident examined Melissa and gave her a series of tests. Some tests I had seen before at Dr. Nowinski's. Others were new to me and looked more advanced maybe smarter, research results based new tests that were just hitting the medical community. He wrote down his findings to presented them later to Dr. Sergott.
Afterwards, the kids and eye were wisked backed to the waiting room while Melissa did some more eye tests in a narrow hallway effectively clearing out the examination room for another patient.
Melissa came out and then waited for us. I assume during the time we were waiting, Dr. Sergott had time to review Dr. Nowinski's notes, that of his resident, and the other eye tests. Our next stop was a meeting with Dr. Sergott. He presented 3 options to us. We already knew what they were. One option was radiation, one option was steroids, another option was surgery to remove some skull bone so the eye had more room. The last option was one we wanted to avoid since it didn't actually treat the symptom. There were risks involved with the first two options because of the pregnancy.
Dr. Sergott examined Melissa and gave us a breakdown of the options and how they applied to us and how we should weight them based on experience from his many other cases involving pregnancy and thyroid/eye issues He leaned towards radiation as the first option but needed to check with a radiology specialist to see if the baby could be shielded sufficiently. Here's were Dr. Sergott put us back in the waiting room while he had an office manager in his staff call down the radiologist and also try to make an appointment that same day.
We were then called back in after Dr. Sergott spoke to the radiologist. The radiologist thought it would not be possible to shield the baby from the radiation. Dr. Sergott then turned to the 2nd option of steroids. For this, he had his office manager call down to UPenn to speak with our OB/GYN doctor. We again went to the waiting room.
The doctors at UPenn worked with Dr Sergott to approve the use of steroids. A major factor was that we were far enough along in the pregnancy and the steroid to use was of low risk to the baby and may actually have some benefits for developing the lungs. Dr Sergott warned that if the treatment did not improve matters, we would have to revisit the surgery option. He let us know what to expect from the first few days of using the steroids. He sent us on our way and we went straight to the CVS pharmacy and had the prescription in 10 minutes.
The story has not ended but is still going on. However, the good news is that a few days after taking the treatment, Melissa is seeing improvement in his vision and we are hopeful that the eye issues will be reversed, maybe not to perfection, but still much better. You have to love it when organizational efficiency, mixed with solid research, experience, and decision making result in a desired result of success. I'll bet you that they have a higher success rate than other Eye hospitals that don't have their shit as tightly together. I wonder how many people die in hospitals because of bad organization and utilization of resources.
If anything, I hope to be able to walk into an organization that is not like this and slowly build an efficiently running machine made up of humans like the Nuero-Opthamology department at Wills Eye Hospital. If I were to write a book, this would be one of the primary examples that I would draw upon. This is going to be the model of operation that I will aspire to.
