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PT and the Greater Good

Down the Rabbit Hole and Through the Looking Glass

Published November 18, 2009 7:50 AM by Dean Metz
What a week it has been! I started working with my new employer, the National Health Service of Great Britain on Monday. On day one it was a pleasant enough general "Hello there" meet-and-greet sort of thing. The staff was fascinated to meet a physio from the U.S.A. They all were inquiring about our health system with things like, "Is it true that you get turned away from the hospital if you don't have insurance?" "I've heard that people lose their homes if they can't pay their doctor bills?" "So if you don't have the money to pay, you can't get treatment?" and more.

On the second day, I attended a government-sponsored town hall meeting about the "Big Care Debate." There are big changes afoot here in the U.K. and the government has come up with some ideas--and they are reaching out to the communities for feedback on which option is most appealing (or least appalling). In attendance were NHS staff, town council members, other providers of service, and--most importantly--users of service, including the elderly, caregivers, people with disabilities and even people with learning disabilities. You can find the background here.

Britain knows that their resources are dwindling and that before long, there will be only two working people for each retired person. That won't be enough to continue funding both the National Care Service and the National Health Service. It is very much like the Medicare dilemma currently going on in the U.S. One thing that is very clearly not an option, and has been voiced to me several times already, is that they will not tolerate denying care to anyone who needs it. This was expressed not just from those with liberal leanings, but also conservatives (Tories) as well.

Later in the week, I attended a day at one of the satellite offices that house an adult day unit and has a fully-equipped rehab gym. The RN falls coordinator is based here and there is a nurse who also provides fall assessments. I see great opportunity here to turn this into a brilliant falls clinic and lab! I will be interviewing a physio to man this facility in three weeks. I'm excited about the possibilities here!

Some other things that I didn't expect:

1. They use a different blood sugar scale here. The United States measures blood glucose in milligrams per deciliter, or mg/dL. Whereas, In Europe and the U.K., it is measured in millimoles per Liter, or mmol/L. So a normal reading here is between four and eight. The first time I heard a nurse say that someone had a blood sugar of five, I thought, "Well, even orange juice won't help that one. Better call 911." Five is ideal.

2. The emergency number here is 999 not 911.

3. Temperature is in Celsius of course. Would you know if someone with a temp of 35 was normal or not?

4. Home Care doesn't end at 6pm here. It is a 24/7 service with nurses making calls throughout the night. I will go into more detail about that later.

So as you can see, there is a big learning curve, lots of cultural competency to master with regard to the health system, and a lot of very exciting challenges ahead.

By the way, I've been driving solo all week and so far the car, the British population and myself have survived.


Enjoying your blog.  And admiring your spirit of adventure.  I appreciate you comments about heath care delivery there, and here, as sometimes there is too much fear mongering about health care delivery on both sides of "the pond".  Keep it up and good luck!

katesel Strimbeck, PT - PT Supervisor, St. Peter's Hospital November 21, 2009 7:04 AM
Albany NY

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About this Blog

    Dean Metz
    Occupation: Staff Development Specialist
    Setting: New York, NY – Newcastle Upon Tyne, Great Britain
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