S1 Ep 3 - Part 2 - Thinking Outside the Healthcare Box: Systems Theory Discussion with Guest Dr. Shelly Smith-Acuña

This is the second part of a two part interview with Dr. Shelly Smith-Acuña. You can read about, or listen to, the first part of this conversation here. I highly recommend tuning in to part one first.

For both parts of this interview, I’ve proposed that Dr. Smith-Acuña and I take a unique look at the health care system. We are blending her background in Psychology and Systems Theory with my own experience of the healthcare system as a doctor. We set the scene for this discussion by having all of the “family members'' of the healthcare family attend an intensive psychotherapeutic session together. We are sending all the players of healthcare to get therapy because, let’s face it, healthcare systems are really dysfunctional.

In this episode, Dr. Shelly Smith-Acuña and I discuss:

• Structure as the fifth principle, and the hierarchy that comes into play within the healthcare system. Structure encompasses sharing power and sharing responsibility, along with good communication.
• How definition and clarity around the structure of a system gives everyone working within it a better sense of how to interact and work.
• History and development is the sixth principle of Systems Theory. This involves understanding both the history of the doctor’s profession, or health history of an individual patient. Events such as trauma are not always considered when approaching care, and they have an impact on outcomes.
• The role of transference and countertransference: unconsciously patients and doctors experience and react to one another based on their past personal experiences and what they encountered in their families of origin.
• Social and cultural narratives is the seventh principle of Systems Theory. Each of us has encountered both social and cultural experiences that inform who we are now, and how we understand any given situation. These narratives also impact language shaping experience and form dominant narratives.
• One example of this is a dominant narrative around passive-aggressive care. Within a healthcare system, the patient is often expected to be a passive recipient of care, with doctors using aggressive approaches and language around care.

Resources

Systems Theory in Action: Applications to Individual, Couples, and Family Therapy by Dr. Shelly Smith-Acuña, 2011.

Wise Mind, as explained by the founder of DBT (Dialectical Behavioral Therapy), Marsha Linehan in this short YouTube video. This Venn diagram is an amazing summary of where two people can be in healthcare interactions, from successful to polarized.

Correction and more information on the 20th-century physician, William Osler. Dr. Osler was actually one of the four founders of The Johns Hopkins Hospital rather than Johns Hopkins University as explained in the episode. For more information about William Osler, click here.

Read a transcript, and the full show notes for this episode on my website.

To learn more about Third Opinion MD, please visit my website by clicking here.

I offer one-on-one integrative health consultations blending Eastern and modern medicine philosophies, putting you in charge of your health management and prevention. You can learn more by visiting my website, here.

Dr. Barbara de la Torre started Third Opinion MD as a way to spark a wave of change in the way we practice medicine, how we care for ourselves, how physicians are treated, and how we can navigate through the existing healthcare system. Information on this podcast is provided for informational purposes only and is not intended as a substitute for the advice provided by your physician or other healthcare professional.