Saturday, April 17, 2010

Patient Centered Care

Patient Centered Care; Born With the Knowledge or Learned?

As I sat next to the elderly patient, who was being prepared for surgery, I watched doctor after doctor come in to speak with her. Alone, if not for my presence, I realized how overwhelming it is to be bombarded by questions by many different strangers, especially when she left her hearing aids at home, as she was told to do.

The surgeon, a physician’s assistant student, the registered nurse, a surgery resident, the anesthesiologist all came through with their own list of questions.

“When did you last eat?”

“What are your past surgeries?”

“What are your allergies?”

“What are your medications?”

The list went on and on. When it seemed to come to an end, the PA student lingered. She chatted with the patient about the patient’s family, travel and life. The surgery resident soon came over to listen and also engage in conversation. Though extremely tired from tests and procedures earlier that morning, the patient was happy to tell stories of her very full life.

I had the opportunity to ask the young medical staff, still in training, if they have ever heard the term Patient Centered Care. They both shook their head and replied “no”.

They asked what that was and I explained that it is treating the patient, not as a disease or illness, but as a whole person. Actually, there are many definitions, that’s the one I chose to use at the time. It is being practiced and talked about in the “patient safety world” I told them.

An article in Family Practice Management explains Patient Centered Care as “treating patients as partners, involving them in planning their health care and encouraging them to take responsibility for their own health” While an article written for Robert Wood Johnson Foundation describes it as “speaking with your patients in their preferred language—at least during critical moments”

By listening to the patient for the extra 5 minutes, these doctors were learning more about the patient’s life and lifestyle. This may be a big part of how the patient will heal after surgery and how she will be cared for. The better the outcome for the patient, the better reputation the doctor will have.

These young people in medicine are learning about the body and how it works, how it fails us and how they can, with their incredibly difficult and long hours of training, can help fix it. I credit them for their skill, their commitment to healing and helping.

I hope that when they realize that their listening skills, empathy and compassion is not just a trait they were born with but also presently a taught skill in patient safety, often not taught until much later in their career, they will continue this practice of Patient Centered Care. I am just surprised this lesson was coming from me.

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