Monday, 8 August 2016

Patient Centred Care - It Begins with Respect


Patient Experience. Empathy. Patient Engagement. Patient Inclusion. Shared Decision Making.

I hear a lot of buzzwords. And a lot of the time, that’s all they are – buzzwords. I’ll tell you what I want, not as a ‘e-patient’ or a ‘patient advocate’, but just as a mom. I want my 14 year old son to leave his 2 hour appointment with his new doctor excited about the care he’s receiving. And that rarely happens. But last week it did. Why? What was different?

In the words of Inigo Montoya from ‘The Princess Bride’ “Let me 'splain…No, there is too much. Let me sum up…”


Our names were respected:  

Right from first handshake, he respected our names. He checked with my son, his patient, how he likes being referred to and made sure to use that name. Amazingly, I was not ‘mom’! I was Ms. Jordan. I had a name – like a respected colleague. Even our family members that weren't there – he took the time to find out their names, to ask the spelling, to check in to make sure that the had it correct. It seems such a minor point, but if you were going into a collaborative business meeting, wouldn’t you make sure that you had the names of your partners right? Would you go into a project with someone who couldn’t be bothered to figure out which was your first name or last name? Names matter. Manners matter.

Our emotional needs were respected:

In recognition that this was to be a long appointment, this new doctor told us exactly what the agenda of the appointment would be. Of course he knew, but respecting our needs as partners meant bringing us in the loop so that we could have a say. And then giving us (giving my son) the power to change locations/moving/pausing if the appointment became too long. Of course, as with most people, knowing what was coming next made it easier to tolerate a long meeting and we were fine with the long appointment time.

Our physical bodies were respected:

Recognizing that the clinic is truly the health care provider’s domain is important. And inviting the patient into it and making us feel comfortable there isn’t something I’ve ever really thought about before. But at this appointment, this doctor said, “I’m comfortable, but others find it cold here. We can move to another room if it is too chilly here. That is no problem”. I don’t think I’ve ever been asked anything like that at other appointments. Furthermore, before examining my son, there was always a pause, an explanation, and a request for permission. Such a small touch, but an indication of respect and partnership and caring.

Our stories were respected:

So at the beginning of the appointment I did what I always do. I shuffled my papers. I organized my files and I got ready to be as efficient as possible, because I have been taught to respect the doctors’ time. Amazingly, this is the response I got (paraphrased) ‘I love data, but before I look at that, I want to hear your stories. [looking at my son] Your story. [looking at me] And your story. And then when you hear my story too, perhaps together we can reach some answers. Not because any of us are telling the truth or a lie, but because each of us has a different perspective.’ I’m sorry, but has this fellow come to see my talks or something? Seriously, he was preaching to the choir! My son and I may have shared a significant look at this point.

In brief, we were treated as partners in my son’s care; as respected equals, as colleagues. I don’t understand why this is both difficult and rare. I didn’t get the sense we were treated this way because we were special patients. I believe this is simply how this doctor treats his patients. To put icing on this already truly fabulous cake, the doctor asked us if we’d like to stay in contact by email so that we can see how a course of treatment is going and course-correct if necessary. Imagine. I am immensely grateful to this doctor for this experience. It reminded me of what is possible. We are fortunate because we have several healthcare providers that are doing so many things right. But this appointment, this day, distilled each of those things into one, single appointment. It made me see how important it is to feel respected in all of our interactions with the health care system. It is something we should expect, not be surprised by.

Respect. Being treated with manners and grace. This is simply how I expect my children to treat others. Isn’t this how we should expect health care providers to treat us as well?