by Rose RohloffMore than ever in today’s healthcare, it is imperative for consumers to champion care themselves or have someone act as their health care champion. People are not experts in disease management and need to know what questions to ask. Individuals will not fully process information while in a compromised emotional state (some refer to only 20% of information being heard and comprehended while under duress) – as the following story demonstrates. A wonderful, young mother of small children contacted me and relayed her experience. She had gone into remission from a potentially life-threatening condition. After eight years of being asymptomatic while off all drugs, she began to experience the onset of new symptoms. With a recent scan performed, she went to a new doctor in her small town to get the scan results, I refer to him as Dr. A.
Dr. A looked at me and asked, “Why are you crying? You knew that you have Multiple Sclerosis since you were in your 20s.” Dr. A did not consider that his patient was now a mother of small children, and her primary concern is always how to care for them - the situation was no longer about herself; she was sitting in front of him alone; and, she now lives in a small town without access to an expert in her disease management. The doctor did not recognize that his patient was thrown off balance by his comment, and she was not comprehending what was being said.
A Healthcare Champion is Always Needed |
| I coined the term health care champion instead of advocate because advocacy has morphed to represent gaining access to doctors and payment/reimbursement. Advocacy is steering to a directory. A champion is a person or team beside you to guide, interpret, do leg work for understanding, monitor for quality, and in many cases fight for you! |  |
As in the case of Dr. A in the precious story, his reaction to care was to immediately start with one of the latest drugs on the market, to be aggressive; however, he did not first consult her previous physician, a specialist, nor was he aware of the patient’s thorough history, and did not review naturopathic options. Champions of care are needed as physicians are now too often conditioned with:
- the "shotgun" approach of running pages of tests hoping to hit something;
- symptom = prescription, take a symptom and throw a drug at it;
- failing to do comprehensive H&Ps, assessments, and clinical diagnosing.
A Partnership Always Needs to Exist for Quality Care
In 2015, I wrote a very explicit definition for Population Health, because as the story of this young mother exemplifies, all other definitions were generic, an extension of public health, and they all lacked what is needed to achieve the health of the population - ENGAGEMENT:
Population health is an established community of people (consumers), working in partnership with health providers, advocates and educators operating holistically as a team within an integrated health maintenance continuum, to perpetually achieve and enhance quantifiably agreed-upon quality of life outcomes.
Digitalization of records and telemedicine programs have demonstrated that small rural hospitals can access the expertise of specialists in larger, urban facilities, especially if the patient was previously seen by a specialist in another state. The problem is telemedicine is misused, for (mis)diagnosing instead of care coordination, care planning and researching/educating. Reactionary diagnosis using telemedicine, such as antibiotic prescribing without culturing, is not using technology for positive outcomes. While using telemedicine for consults, researching and follow up dialogue with patients and their family/champions has shown to be very successful. Telemedicine also enables pulling in champions/family during office visits! Physicians need to embrace collaboration, remembering technology does not replace clinical intelligence; but used correctly, technology can be leveraged as wonderful tools for true care coordination. Technology tools are not solutions; tools can be used to enhance processes, or be misused to perpetuate bad practices.
A career physician told me years ago, "Being a doctor used to be a calling: Today, many physicians see it as just a job, without a desire to put in the hours and work often needed establishing a rapport with patients."The previous story I shared, about a young mother addressing the news of the possible relapse of a disease, demonstrated the importance of having a healthcare champion.
I read the June 2017 article in BECKER’S Hospital Review, “Younger physicians may have less faith in the Hippocratic Oath, which has a patient focus, because they feel it no longer holds in today's healthcare environment in which many needs compete for their attention.”
The notion that the oath or code of ethics, being patient focused, does not hold in today’s healthcare is poignant because … “there is art to medicine as well as science, and that warmth, sympathy, and understanding may outweigh the surgeon's knife or the chemist's drug.”*
*The modern version of the Hippocratic Oath was written in 1964 by Louis Lasagna, Dean of the School of Medicine at Tufts University. [Similarly, the AMA Medical Code of Ethics.]
Realistically, physicians are pulled in multiple directions, and in many cases overloaded with people requesting to be seen: This does not mean that physicians should lose sight of how to respond with patients, keeping them the focus, nor should reimbursement needs and learning electronic medical records supersede the patient. It does mean with more volume demands, physicians need to rely on a team approach for providing comprehensive communication, alignment with patient’s understanding of things and their wishes, along with realizing that oaths and the code of ethics hold clinicians to a higher standard. The team approach is necessary for quality care and caring, including the person being cared for and their champions.
A career physician told me years ago, "Being a doctor used to be a calling: Today, many physicians see it as just a job, without a desire to put in the hours and work often needed establishing a rapport with patients."The previous story I shared, about a young mother addressing the news of the possible relapse of a disease, demonstrated the importance of having a healthcare champion.
I read the June 2017 article in BECKER’S Hospital Review, “Younger physicians may have less faith in the Hippocratic Oath, which has a patient focus, because they feel it no longer holds in today's healthcare environment in which many needs compete for their attention.”
The notion that the oath or code of ethics, being patient focused, does not hold in today’s healthcare is poignant because … “there is art to medicine as well as science, and that warmth, sympathy, and understanding may outweigh the surgeon's knife or the chemist's drug.”*
*The modern version of the Hippocratic Oath was written in 1964 by Louis Lasagna, Dean of the School of Medicine at Tufts University. [Similarly, the AMA Medical Code of Ethics.]
Realistically, physicians are pulled in multiple directions, and in many cases overloaded with people requesting to be seen: This does not mean that physicians should lose sight of how to respond with patients, keeping them the focus, nor should reimbursement needs and learning electronic medical records supersede the patient. It does mean with more volume demands, physicians need to rely on a team approach for providing comprehensive communication, alignment with patient’s understanding of things and their wishes, along with realizing that oaths and the code of ethics hold clinicians to a higher standard. The team approach is necessary for quality care and caring, including the person being cared for and their champions.
Great healers understand we always learn more about God's great creation, being in the infancy of comprehending what He has designed.
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