Lots of millivolts zipping and zapping from one neuron to the next neuron.

So can we, the medical doctors and medical researchers, figure out how to use electricity to tune up the brain?

That’s the BIG QUESTION.  

But the brain is the most complex structure in the universe aside from the universe itself.

But the work of using electricity to tune up the brain of those with mental health challenges is well underway.

Depression , for example, involves multiple neural circuits. This is different in different patients. So what is needed is a personalized approach to using electricity to treat depression.

The personalization is based on brain mapping of brain activity. EEG does that trick.

And then electrodes are programmed to target areas of the brain involved in creating depression.

This is like a pacemaker for the brain.  Deep brain stimulation with leads deep in the brain has been used for decades but it is very invasive and very expensive.

So transcranial brain stimulation using MRI targeting is a much less invasive and more accessible approach to treating depression and other conditions such as OCD.

Personalized brain stimulation requires accurate targeting of the right area of the brain but also the right rhythm. The neural code or the brain code is frequency dependent.  Like a song. Get the frequency wrong and Taylor Swift’s song is gaarbbage.

So the brain is and has been proven to be plastic. It can be rewired and using electricity in targeted and personalized methodologies will help humanity with the biggest illness of all – mental illness.

Raymond Rupert  health system disruptor and patient advocate.

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It was very sad to hear their stories of loss.

One family had lost their husband and father. He was 53. A loving, caring and previously healthy father of 4.

The last time, his wife had talked to him was by facetime the day that he died.

He was in the hospital ICU for 65 days.

After he died, the wife got a thick envelope from the hospital.

It was the itemized hospital bill for his care.

The interviewer on 60 minutes asked how much that it totalled.

She said $4 million dollars.

At the start, she did not know if her health insurance would pay for the bill.

There is something immoral about having sustained this level of personal loss and then traumatizing a grieving family with a hospital bill that represents the worst elements of healthcare capitalism in the USA.

Raymond Rupert

CEO

RCM Health Consultancy Inc.

info@rcmhealthconsultancy.com

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Unfortunately, if the child sustains adverse childhood experiences (ACEs) including trauma, separation and abuse, then there are likely to be resulting mental health concerns and challenges.

So planning for mental health for the family starts on day 1 of the infant’s journey in attachment and brain development.

If mental health challenges do arise, then the quality of socially and emotionally authentic relationships within the family are the key to helping the person with the mental health challenge.

The analogy often used in mental health involves the use of the oxygen mask on the airplane. The first thing to do on the airplane is for the parent to put on the oxygen mask and then the parent can help the child.

The parents have to take care of their mental health first in order to help the child.  The parents must be emotionally healthy in order to help the child.

The family system is an important part of our work at RCM Health Consultancy.   In family systems work, we look at the existing narrative within the family system.

The narrative is what the parent’s think. It is their assumptions about the child. If the problem has become entrenched and the parents have suffered with the problem for a decade or more, they might assume that nothing can be done. And then nothing will be done.

We recently spoke with the parents of a 30 year old child assumed to have “failure to launch”. The parent’s narrative and assumptions were that the child was not capable of becoming a productive and purposeful individual. When we offered to help with the narrative and assumptions, the parents said no thanks.  Nothing will change because of their assumptions which stopped any possible progress from being made.

If the narrative and assumptions can be unpacked and changed and a new more positive and optimistic outlook is adopted , then the ensuing changes in the conversation and actions might in fact work to help the child.  At least, an effort will be directed at changing in a positive and healthful way.

Challenges exist at this stage of implementing change, as well. Having the parents look at their own enabling behaviours is very difficult. It is hard work to change what is unexplored. Even if the parents had the best intentions in raising the child, things can go wrong.

Once the parents have examined their enabling behaviours,  and then changed the conversation and their actions including introducing consequences , then things might get worse before things get better. That is to be expected. So put on your seat belts for the bumpy ride and be patient.

This describes the family systems work that we do at RCM Health Consultancy when families commit to work with our teams in helping a family member with a mental health problem.

Raymond Rupert

CEO

RCM Health Consultancy Inc.

647 350 5500

info@rcmhealthconsultancy.com

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That is a certainty and all you have to do is look at the stats to see that it is a reality for many families.

It is time to start putting a plan in place for these mental health crises. Or the vague reference by a family member to ending it all might, in fact, happen.

In planning for a mental health crisis, it is important to realize that the family doctor is not likely going to provide the solution. And the healthcare system won’t likely provide a solution. A patient might be admitted to hospital for a crisis but that is just the beginning and not a solution. Solutions have to be crafted one patient at a time with a team with deep expertise in this field.

A family needs a mental health advisor to take the role of mental health coach. The mental health coach’s job is to build deep and trusting relationships with the family members. He/she has to understand how to use langugage to build trust.  And how to engage the family members either individually or as a group.

The mental health coach should have training in the assesment of mental health conditions. RCM Health Consultancy team members can take this role and RCM is able to provide an audit of the mental health status of the family members. Or at least an audit for those where there is some concern.

The family member will get feedback on their metrics and understand that if the family member wants help that the mental health advisor/coach can help to guide them on a treatment pathway. Crafting the treatment pathway requires a multi-disciplinary team with various skillsets.

This is a complex role. If there are 4 generations in the family, and an individual can have any of 30 conditions and if there are at least 40 different options for that person, then there are 4800 different scenarios to possibly consider.

This is a complex decision that a family needs to consider and hopefully with a team of professionals supporting their decision. That is what we do at RCM Health Consultancy.

A  family can call RCM Health Consultancy Inc. to learn more about how RCM can assist the family to prevent mental health crises.  We are always pleased to assist.

Raymond Rupert CEO  RCM Health Consultancy Inc.

647 350 5500 ext 118 /   info@rcmhealthconsultancy.com

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She tested negative for COVID in early January. Her 5 family members all tested positive.

She did develop symptoms of COVID with productive cough, loss of sense of smell and taste, muscle aches, myalgia, gut pains and intermittent headaches.

This was classic for COVID and post COVID syndrome even though her COVID test was negative.

She reached out to her GP who had been her GP for 20 years. His office announced that they don’t see or treat COVID patients.Betsy said that he is much more interested in the botox part of his practice.

Betsy was feeling worse and somewhat short of breath. She went to the ER. The ER doctor measured her oxygen saturation. It was 84% which is low. It should be over 95%.  He admitted her to the hospital. When she got upstairs, another doctor saw her. Her oxygen sat was 95% so the doctor discharged her with no meds. No followup. Nothing.

Betsy’s company has a corporate account with an executive checkup company. This is a concierge care service. When she called, the nurse would only text with her. They never spoke. The nurse said that she could not do anything. She had no access to the ER records and she must go back to her GP.

So that is the state of the customer experience in some primary care settings.

I feel sorry for these patients who are not getting the support, advice and care that they want and need.

That is why we offer a service to meet these types of needs on an expedited basis.

It is described at www.quest-executive.com

Raymond Rupert  CEO  RCM Health Consultancy Inc.

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If family doctors give about 50% of all flu vaccines, then why would Public Health not involve family doctors in the distribution of COVID 19 vaccine?

This is a head scratching moment.

Lives depend on this very poor decision about distribution.

Who is making this decision? Public health? Provincial health? The Feds? The bureaucrats? Who?

Has anyone asked the authors of BlitzScaling what to do? That is Reid Hoffman and Chris Yeh.

If you asked Hoffman, of Linkedin fame, and Yeh what to do they would say that we need “SCALEABLE DISTRIBUTION”.

Using hockey rinks and community centres for COVID 19 vaccine distribution is not scaleable distribution.

Using established distribution channels such as family doctor’s offices and pharmacy chains is scaleable distribution.

The Public Health folks should ask logistics experts knowledgeable in healthcare what to do and not those with the knowledge of moving tanks and battalions.

Ask the experts at the Rotman Business school or the Schulich School of Business or the Ivey School of Business about scaleable distribution of COVID 19 vaccine.

Lives depend on how this is done.

Why are we acting like ludites when approaching Vaccine distribution?

And let’s not forget about the vaccine database that is being developed too late to be of any use.

That’s another $16M mistake.

Let’s put the smart and informed decision makers to work fixing this mess.

Raymond Rupert patient advcoate and health system disruptor for the public good.

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The sum of an person’s observable characteristics is their phenotype. A key difference between phenotype and genotype is that, whilst genotype is inherited from one’s parents, the phenotype is not. Whilst a phenotype is influenced the genotype, genotype does not equal phenotype

Any digital phenotyping systems used to track a person’s mental health status will be inaccurate. There is no such thing as a 100 per cent accurate medical test, and it’s important to consider the potential misuse of any mental health data.

But to dismiss digital phenotyping because of these limitations is to miss its potential utility. At the very least, a person’s smartphone information could help to inform their clinician’s decision-making and the mental health care that they provide.

Even if a test can’t be used to home in on an exact diagnosis, it could narrow down the range of possibilities and ultimately help inform human judgment and treatment-path selection in a field that needs better diagnostic tools.

Traditional mental health care relies on a person self-reporting their symptoms, which can be unreliable. Furthermore, once a therapy session is over, there’s no established way to monitor a patient’s thoughts, feelings or behaviour in their real life.

Thus, being able to assess mental health objectively and continuously by analysing a person’s daily digital footprint offers a transformative alternative to traditional methods. Digital phenotyping will be an important tool for use in mental health care.

To learn more call RCM Health Consultancy  647 350 5500 or email us at info@rcmhealthconsultancy.com

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The search for suitable anti-inflammatory drugs for covid-19 has already turned up one, dexamethasone. It is a cheap steroid that dampens the immune system across the board.

In contrast, tocilizumab and sarilumab are more targeted. They are both made of antibodies that block the effect of interleukin-6, a protein that stokes the immune response and has been prominent in patients with covid-19.

Nearly 36% of patients in the standard-treatment group died, compared with 27% of patients in the group that also received tocilizumab or sarilumab. In other words, it cut the death rate by about a quarter.

Moreover, the patients treated with these drugs recovered faster and were discharged from hospital 7-10 days earlier.

source: The Economist  Jan 7 2021

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This case conference proved to be magical for the family. Raymond Rupert of RCM Health Consultancy was the facilitator. The 3 specialists were able to explain their viewpoints in plain English. The 3 specialists agreed on a neurosurgical procedure for the patient.

The logic and rationale were explained to the family for the first time. The family was able to understand the implications of the surgery including possible side effects and complications but also to understand the possible benefits. Emphasis on possible.

The team at RCM Health Consultancy is committed to organizing case conferences for our clients in order to give patients and their families the opportunity to contribute to the narrative, to understand the basis for decision making and for RCM to advocate for our client’s rights to access appropriate care.

Raymond Rupert patient advocate & healthcare consultant.

info@rcmhealthconsultancy.com

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source: McKinsey Dec 15 2020

The healthcare sector may consider shifting its focus from short-term mental health “fixes” in the aftermath of acute events and toward the development of an integrated framework to address clinician mental health and the long-term effects of trauma.

While the precise formulation of individual programs will vary, there are a set of principles that should inform any new mental health framework.

Providers can consider embedding mental health training through education, deploying regular risk assessments for all students and staff, establishing new structures within the organizational hierarchy to prioritize mental health and well-being, and procuring resources dedicated to supporting clinicians who require safety net services.

These are essential services that warrant immediate implementation. Healthcare providers during COVID are experiencing continuous and cumulative trauma. The destructive impact of trauma must be countered by developing resilience building capabilities for these providers.

Source: McKinsey Dec 15 2020

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