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?  

4 comments:

  1. This is SUCH a great story about this physician, a true champion of patient centred care. I only wish these stories were not so rare. I liked your analogy to treat an appointment (at the very least) like a business meeting. This would infuse the most basic of respect, such as handshakes and introductions. Why do the most simple, common-sense behaviours immediately evaporate in health care environments? Thank you for reminding us that it CAN be done.

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    1. Thank you Sue. It does perplex me as to the rarity. People often cite the fact of 'there's only so much time', but really, good manners don't take more time. I think it's more of an attitude. I wish I could take this doctor's attitude (and that of a few others I'm fortunate to know), bottle it and give it away for free. The trick would be to convince the others that it's something they both want and need. ;)

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  2. Isobel, what an amazing experience and like you say, too rare. I love how you've laid it out. And, yes, it is about manners and common courtesy. I'm so pleased for you both that you have this relationship. It bodes well.

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    1. Thank you Alies for the kind words. We are very lucky to have some good relationships with a few of our health care partners. But when you've had as many as we have, there are certainly some that miss the mark! The trick now, is to figure out what to do about the ones that don't make this kind of relationship a priority. Can we change it? Do we suffer through it? Do we change the health care provider? It's tricky.

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