The concept of patient-centered care – treating the entire patient, not just the disease the patient is facing – should not seem so far fetched. But for many in today’s healthcare landscape, even the idea of working this way requires overcoming significant obstacles and hurdles believed to be necessary for treatment.
At Verdi Oncology, however, we believe that putting the patient first is critical to successful treatment, and that’s why we’ve adopted the patient-centric approach.
There are several key tenets to patient-centric care.
James Rickert, an orthopedic surgeon and faculty member at the Indiana University School of Medicine, outlined in an article published by HealthAffairs that one of the biggest challenges in healthcare today is a lack of a trusting relationship between patient and physician. He cited the example of a woman who failed to return to her pulmonologist after he had performed tests and prescribed medicines — all with a very hands-off approach — which resulted in no improvement in symptoms. By the time the woman sought additional opinions, she had been diagnosed with metastatic cancer.
“The underlying problem … is the lack of a relationship between the patient and her doctor,” Rickert wrote. “This patient never felt any personal connection with her doctor; from her point of view, the visit was an expensive waste of time, and, therefore, she did not return for further treatment.”
Creating an empathetic environment is key to building these kinds of relationships, particularly in an oncological setting, as well as not simply defaulting to performing additional diagnostic tests or prescribing medication.
“Doctors who are not engaged in patient-centered care often order expensive tests or referrals as a poor substitute for connecting well with their patients,” Rickert wrote. “Several studies document higher utilization rates for diagnostic tests, hospitalizations, prescriptions, and referrals among doctors who are poor communicators.”
Creating open lines of communication is critical, and even more so in oncological settings. This is true both between the patient and the physician as well as with the patient’s family, caregivers, and any other physicians providing treatment. This means that transparency is essential, especially among healthcare providers.
In fact, communication is so important that the American Medical Association brought in Ronda Zalman, a marketing and communications expert, to offer recommendations to medical students on how to improve communication in the first days of their clinical rotations.
“Explain your recommendations, what you’re doing and how you’re doing it,” Zalman said.
Listening to the patient
In addition to improving communication, Zalman said that physicians should give patients their “full, undivided attention,” and “hear their stories.”
Listening is critical to building trust.
It’s also, as Rickert noted, an important yet often missed measure of successful treatment. He cited the example of a patient who, by the numbers, had a statistically successful hip replacement. However, the patient was never asked his satisfaction level. Due to the pain, the patient was experiencing post-surgery, many revisions to the replacement were necessary, resulting in additional pain and multiple hospitalizations.
“While the score [of the original replacement] seemed reasonably accurate, it, obviously, in no way correlated with the experience of this patient,” Rickert wrote.
Treating the entire patient and not just the disease also means that there are other aspects to a patient’s well-being that need to be considered, particularly around mental and spiritual issues. In addition to these sensitivities, physicians should be cognizant of a patient’s cultural, social and environmental needs.
In oncology, in particular, a patient is likely to have fears, worries, and other emotional distress symptoms that cannot be ignored in a patient-centric approach. Connecting the patient, family members, and caregivers to support groups and other resources is a key component to successful care — one that extends beyond the physical treatment alone.
Rickert summarizes patient-centric care as three basic principles — relationships, communication, and empathy. These are three principles that we believe are critically important to successful oncological care and why we’ve adopted the patient-centric approach to care at the core of our practice.
- “Patient-Centered Care: What It Means and How To Get There,” James Rickert for HealthAffairs “Patient- and Family-Centered Care: A Systematic Approach to Better Ethics and Care,” American Medical Association Journal of Ethics
- “6 simple ways to master patient communication,” American Medical Association
- “Person- and Family-centered Care and Peer Support,” Substance Abuse and Mental Health Services Administration