ABOUT


"To know and understand...is a dimension of being scientific;
to be known and understood is a dimension of caring and being cared for"
George Engel 


This website, Hygeia.org® (after the Greek goddess of health and healing), concerns the human dimension of healthcare and uses new technologies to share age-old feelings and lessons. In an age of advanced medical technologies and changing paradigms in health care, Hygeia® strives to assure that as benefits of these technologies are fully realized, their expanding sphere of influence does not disenfranchise the patient, depersonalize the physician-patient relationship. Obstetrics in 2016 is a paradigm for safe, patient-focused care. Families achieve optimally healthy maternal and newborn outcomes in an atmosphere of effective healthcare provider communications, a shared decision-making process between and among clinicians and nurses (teamwork) and evidenced / experientially based practices all occurring within a milieu of consistent and compassionate care which generates trust, the hallmark of the doctor-patient relationship. When unexpected outcomes do occur and /or technology fails to achieve its intended purpose, there must be avenues to foster understanding, administer compassion and promise hope. This is the human dimension of healthcare; this is Hygeia®

BRIEF BIO

I am a 1970 graduate of New York Medical College. After my post-graduate training in Obstetrics and Gynecology at the Yale School of Medicine and Yale-New Haven Hospital, I joined the clinical faculty at the Yale University School of Medicine.  As Clinical Professor in the Department of Obstetrics, Gynecology and Reproductive Sciences, my work focused on helping families who experienced the tragedy of Perinatal and Neonatal Loss.  I am a recipient of the Association of Professors in Gynecology and Obstetrics Teaching Award, the C. Lee Buxton Teaching Award, and have been interviewed about my work by the New York Times, the Student British Medical Journal, the CBS Early Show, the NBC Today Show and most recently by Yahoo Health.

I joined the faculty at Mount Sinai Beth Israel Medical Center in 2012 as the Medical Director of Labor and Delivery and Associate Chairman for Quality and Patient Safety. In this role, I instituted a Laborist Program which has grown to 4 full time, Board Certified Laborists, working as a team to provide standardized, evidenced-based, patient centric care to all patients on the labor floor while enhancing the quality, safety and the patient experience. I direct all the Quality and Safety initiatives in the Department and works in concert with the Mount Sinai Health System institutional QI and patient safety teams. Throughout my career, my focus has been to promote and provide optimal, high quality medical care to a diverse population of patients. I have done so always seeking out an opportunity to involve medical students and residents in my deliveries, rounds, surgeries and office practice and my philosophy of care. I am the author of the book, Parenthood Lost: Healing the Pain after Miscarriage, Stillbirth and Infant Death and many poems and essays documenting the human condition and how physicians and healthcare providers affect and are affected by their patient’s experiences. My recent manuscript is, When Love Impales the Heart, A Doctors Poems of Eulogy and Celebration.  I am a charter member of the International Stillbirth Alliance, serving for several years on their Scientific Advisory Board. In June, 2014, I received a Master’s Degree in Biomedical Informatics at the Oregon Health and Science University, with a major focus on personal health records and disparities in access to health-care information technologies (“Digital Divide”).

Coincident with my clinical practice,  I founded and directed the Hygeia Foundation, committed and mission-driven to improve universal access to healthcare services and healthcare information regarding pregnancy and neonatal loss with respect, dignity and advocacy to underserved, vulnerable and disadvantaged women and families. Teaching to our medical students the tenets of humanism, compassion, professionalism, communication and caring for a diverse, vulnerable population- imbedded in the philosophy of the Hygeia Foundation- was a natural extension of this work. In collaboration with the Department of Obstetrics, Gynecology and Reproductive Sciences at the Yale School of Medicine (YSM), I proposed and implemented a seminar series for each medical student rotation entitled Seminars in Perinatal Loss and Bereavement which addressed the emotional, ethical and truly human feelings we as medical professionals experience as we care for our patients. Unique to this program was the quarterly discussion between medical students and mothers who had endured pregnancy losses. The mothers came to the hospital and related their experiences and described opportunities for improving their care. When I joined the faculty at Mount Sinai, I introduced this educational seminar to our 3rd year Medical Student rotation. Entitled, Aspects of Pregnancy Loss: a paradigm for humanism in the care of our patients, our discussions are intense and cover themes such as why have we chosen the health professions, how can we heal when our patients (or their children) are incurable, and understanding the privilege of caring. During the course of the sessions, I introduce tools of narrative medicine, reflective writing such as poetry and journaling. An integral part of the lessons and discussions relate to the medical student and /or physician as the “second victim”, the toll that adverse outcomes, injustices for access to healthcare for the disadvantaged or the emotional burdens of a patient’s death brings to bare on the student’s well-being and how he/she can best endure these inevitable, impactful experiences. 

PERSONAL STATEMENT

I am first a physician, a distant disciple of Aesculapius and Hippocrates[1]; a clinician, a teacher, a mentor and a student. I am an Obstetrician. I stand before my patients[2] and facilitate their births.  I share their joys, I feel their pains.  Yet, caring for the well being and the illnesses of patients and their families is to accept that medical science in all its depth and possibilities is not precise and that human mind and flesh are perishable.  We are today steeped in myriad medical technologies that in themselves bring hope to previously hopeless conditions and pathologies.  Yet there is inexorable suffering which accompanies failures and tribulations of all new medical technologies.  The paradox of new technologies to cure and cause pain is real and evident. I believe that I as a physician have been granted by oath and by ethic the privilege to examine and treat, to counsel and advise a fellow human being while using albeit modulating the use of these technologies. Indeed, the future is bright for medical innovation and the alleviation of suffering, but we must be careful not to allow this technology to wedge the doctor/patient bond. We must recognize and heal those ‘unspeakable’ losses evident when medicine and technology can longer treat and the physician can longer cure for when technology fails, the physician must not. Physicians must set their patients and their families on a course of acceptance, comfort and understanding. We must sit at their bedside and in the pews at their funerals for when our deeds and actions, our skills and intuitions no longer can heal, we must not abandon the soul of our patient.  These tenets must be propagated and preserved in the education today of tomorrow’s health professionals. 

Medicus Nihil Aliud Est Quam Animan Consollatio"[3]

The best doctor is also a philosopher.”[4]  Inherent in what defines the physician-patient partnership is an unfaltering responsibility of the physician and an unconditional trust of the physician by the patient.  Together these bond the chasm between the vulnerable patient and the knowledge and experience of the physician; a synergy of the need for care and the privilege of caring.  I believe the medical professional at all levels must step back from each moment in his/her patient care routine, and reflect on what he or she is doing, why it is being done and what influence it is having on their patient’s lives. This self-reflection is integral to professionalism for it encourages the formation of a philosophy of care and ethic of practice, which in turns fosters self-examination and meaning, empathy and compassion. [5]

Poetry is my venue for “self-reflection”. A synergy exists between poetry and medicine for each share from their origins themes of life and death, sorrow and despair, love and futility, promise and hope. A simple poem can transfer frosts of despair and gleams of elation inwards, and when written on the occasion of a birth or a death, a tribute or a memorial, a secret feeling or a revealing epiphany- when these poems have a name and a reason- they answer in the affirmative, “does poetry matter?”[6]

I am increasingly engaged in dialog with my students and young faculty members about the privilege of being a physician, why we do what we do and how we can best help serve our patients. This is a most promising time to become a health-care professional for there is in our immediate future enormous promise in human genomics, cancer therapies and other capabilities of advanced medical technologies. Yet, we must infuse this science with humanism[7].  We need to assure that the benefits of these technologies are fully realized and that their expanding sphere of influence does not disenfranchise the patient, depersonalize the physician-patient relationship and above all, that they permeate each and every family in every community.

Like most every physician, my career is rich in poignant stories of patient’s lives and illnesses, which have impacted and shaped my career.  All have juxtaposed finite technology with the ephemeral human condition rendering both hope and tragedy.  My patients have been my teachers, etching in the crevices of my mind human lessons and insights. Their medical, surgical and emotional travails helped me become a complete physician. Poetry has enabled me to ask why even when we already understand how. It permits me as a doctor of medicine, witness to the frailties of our humanity, to abet healing through the very core of what makes us human, our language and our personal emotions.  It is my platform to tell my ‘ stories, to honor my friends, and grasp the essence of the “family of man”.  It is my hope that this volume, collected on the occasions of loss and celebration, love and understanding, observation and introspection will permit the reader to borrow my words in times when theirs are lost.



[1] In Greek mythology, Aesculapius, son of Apollo, the god of healing, was a famous physician. His mother, Coronis, a princess of Thessaly, died when he was an infant.  Apollo entrusted the child's education to Ciron, a centaur, who taught Aesculapius the healing arts. Aesculapius was skilled in surgery and in the use of medicinal plants.  Hygeia was his daughter and considered the goddess of health and healing.  Hippocrates, a member of the Asclepiadae- priest physicians whose origins may be traced to the mythical personage, Aesculapius- referred to Hygeia in his oath which begins: "I swear by Apollo the physician and Æsculapius, and Hygeia..."

[2] Obstare from the Latin meaning    “To Stand before”; the root word of  Obstetrics

[3] A Latin Proverb translating to:"A Doctor is nothing but the constellation of the soul"

[4] Proposed by Greek Physician Galen of Pergamum  c.150 BCE

[5] Professionalism is the basis of medicine's contract with society. It demands placing the interests of patients above those of the physician, setting and maintaining standards of competence and integrity, and providing expert advice to society on matters of health… Medical Professionalism: A Physician Charter (Abstracted from Annals of Intern Medicine 2002;136:243-246)

[6] Dana Gioia, Does Poetry Matter,

[7] Humanism-“The concept that concern for human interests, values and dignity is of the utmost importance to the care of the sick.”American Heritage Dictionary

 

HYGEIA HEALTH SYSTEMS, LLC (HHS).

The programs and services of HHS advocate for the safest possible healthcare experience. The foundation of this quality experience begins with optimal communication between the patient and the healthcare provider. Families achieve optimally healthy outcomes when their care and resources are provided in an atmosphere of

Open (transparent), effective healthcare-provider communications

A shared decision-making process between and among families, clinicians and nurses (teamwork)

Evidenced / experiential based practices -all occurring within a milieu of consistent and compassionate care.

Support that fosters understanding, compassion and hope; the human dimension of healthcare.

Health Systems LLC (HHS) is an entity which provides programs and services to the public, to healthcare teams and others with a mission to enhance communication, clarification, engagement, quality, safety, trustand humanism (the need for healthcare to be personal and humane with empathy and compassion) withinthe healthcare system.

Health Systems, LLC provides its transacted business through Internet-based programs, programs distributed as Software as a Service (SAAS), personal communications (virtual and face-to-face) and the rendering of professional reviews publications, discussion groups and lectures. 

Improving Safety in Obstetrics

Hygeia Health Systems, LLC has introduced its first commercial software program, Labor and Delivery Scheduling Program ( LDSP™ ). 

Background

LDSP™ is an essential component to an Obstetrical Labor Floor Quality and Safety Initiative.  The program’s customized algorithms permit Labor and Delivery administrators to assure that the timing of scheduled deliveries are appropriate and within recommended guidelines.  This feature alone provides assurance that neonates will not be delivered too early.

LDSP™ is a scheduling tool for all Ob Practitioners which:

  • Provides a legible and organized schedule for inductions of labor, C-sections, and other necessary scheduled procedures.
  • Introduces hard stops and decision support for all scheduled inductions of labors and cesarean section.
  • Prints out daily schedule and individual patient information sheets that comply with Medicaid Rule-Medicaid Redesign Team (MRT) Initiative 5402.
    • Print outs of the daily schedule both in a spreadsheet format and a text-based page layout to be scanned or inserted into the patient’s chart.
  • Enables an opportunity for discussions between providers and patients about timing of inductions of labor, trials of labor, versions, ambulation, returning to home during latent phase labors, etc.
  • Encourages discussions between providers and MFMs regarding indications, management plans, etc.


LDSP™ Provides the following features:

  • Maintains a SQL Database for future statistical evaluation / research.
  • The proprietary program files, algorithms, dashboards, report generators and all other code are customized to the needs of the customer and licensed as such.
  • A webpage which serves as the dashboard for the entire program.
  • Resides on customer’s secure server and can be available on all secure network servers and / or by use of VPN, which must be setup by individual end user after and / if they obtain authorization.
  • Customized menu of Obstetrical Best Practices and assorted Patient Information handouts available at all times.
  • Enables all authorized users to have the ability to schedule their own patients at the point of care assuring that the procedure, date and time are confirmed and / or approved by an MFM when approval is required.
  • Enables all authorized users and /or admin may cancel (remove) the patients from the schedule if they should deliver prior to the scheduled date to free up the time slot.
  • Proprietary decision support algorithms to assure compliance with timing of scheduled deliveries for each indication
    • algorithms will assure that only one procedure of one type (i.e. induction of labor vs. C-section ) will be scheduled per desired day, date and time slot
    • Day, Date, Month and Time of scheduled procedures to conform with scheduling requirements of the Department
  • Menu of all providers authorized to schedule their patients and procedures
    • Menu of all MFM specialists available to authorize (approve) the timing of the scheduling of deliveries with certain high risk indications
    • Automatic calculations of:
      • Gestational Age
      • BMI
      • Output
  • Considerations for Blood management / Cell Saver reservations are built into a mandatory input field. A schedule for those patient’s requiring Cell Saver can then be accessed by the Blood Management / Perfusionist Team and they can be prepared and available for the procedure.
  • A customized reporting module is available as an add-on to the authorized administrator dashboard to provide reports based on all fields in the Database.
  • Customer training / support
    • on site
    • phone / email

 

For more information about LDSP™ or to request a Demo for your Labor and Delivery Unit,


Contact HHS® at: 
info@hygeia.org

I am anxious to continue to teach and engage conversations about the core values of the Profession of Medicine and how they are needed now, more than ever, in the changing paradigms of modern medical practice and healthcare delivery. I am available to speak about these topics in diverse forums, large and small.  You can inquire about my availability HERE 

Michael R. Berman, M.D.
Founder and President
Hygeia.org
®
Hygeia®Health Systems, LLC