Hi everybody & welcome (back) to Notes from the Front —
In this episode, we talk with Dr. Anthony DiGiorgio, a neurosurgeon at Zuckerberg San Francisco General - the leading trauma center & public hospital in the city of San Francisco.
This discussion focuses on the challenges of treating brain & spinal injuries in patients who are marginally housed, homeless, and/or struggling with addiction to substances like methamphetamine and fentanyl. We discuss the legal and ethical aspects of neurosurgery and trauma care, including patient capacity and conservatorship. Dr. DiGiorgio also offers insights into how policy and culture shape healthcare, drawing critical distinctions between the healthcare systems in Louisiana and California.
I found this conversation fascinating, and I hope you will too.
~ Michelle
Chapters
02:17 A Day in the Life of a Neurosurgeon
04:01 Elective and Emergency Injuries
05:46 The Reality of Uninsured and Homeless Patients
07:36 The Cost and Challenges of Long-Term Care
09:51 The Impact of Policy and Culture on Healthcare
17:47 The Struggle with Patient Capacity and Conservatorship
23:24 The Role of Drugs in Traumatic Brain Injuries
29:15 The Legal and Ethical Aspects of Patient Care
33:56 Comparing Healthcare Systems in Different States
38:13 Understanding the California MCO Structure
38:48 The Impact of MCOs on Long-Term Care
40:29 Comparing MCO Systems: California vs. Louisiana
41:02 The Complexity of MCO Systems
41:22 The Role of Politics in Healthcare
41:37 The Challenges of MCOs and ER Care
42:26 Advocating for Change in the Healthcare System
42:48 The Importance of Patient Autonomy and Choice
45:28 Addressing Substance Abuse and Mental Health
47:22 The Ethics of Capacity and Decision Making
47:47 The Impact of Drug Addiction on Health
49:31 The Struggle with Patient Autonomy and Treatment
52:04 The Consequences of Uncontrolled Drug Use
57:11 The Ethics of Using the Term 'Zombies'
01:06:56 The Role of Work Requirements in Healthcare
01:17:16 Final Thoughts and Recommendations
Further Study & Resources
Books:
Poverty & The Myth of Healthcare Reform by Richard (Buz) Cooper
The Least of Us: True Tales of America and Hope in the Time of Fentanyl and Meth by Sam Quinones
Charities & Causes:
More about Dr. DiGiorgio:
P.S. If you have read this far… A special request. I am seeking all the feedback I can get! Please feel free to leave any thoughts or ideas by clicking the button below. Alternatively, you can email me directly. Thank you in advance! ~ MT
Treating Traumatic Brain Injuries in the Addicted