Saturday, June 11, 2011

New Column on Communicating with Your Health Care Team

At the request of the moderator of an online support group for people with Myeloproliferative Neoplasms (MPNs) and their caregivers, I will be writing a regular column, "Communicating and Connecting", that focuses on helping patients and caregives communicate with members of the health care team. (As noted in my previious posts, I have a MPN, Polycythemia Vera, that is currently is being controlled with medication.)
"This is my first installment of this column, which I am very excited to humbly offer to the readers of MPD Chat. Thanks to Beverly for inviting me to share my thoughts about communicating with your health care team, a topic that has been a central focus of my entire 30+ professional career as a physician educator and part-time researcher.

I must start by apologizing for being tardy with this first offering, as I had promised Beverly I would send it to the group on Tuesday, and it is now past midnight on Thursday. I fell asleep at the computer on Tues eve. I am not the night owl I used to be, which I attribute to a combination of aging, my PV and the interferon I have been taking for more than 18 months.

In this first column, I thought it would be useful to share a little bit about me, so you have some context by which to judge my viewpoints, and associated bias. I am the grandson and son of physicians and grew up feeling awe and admiration for both my grandfather and dad. I actually began hanging out in my father's office, which was in my house, at the age of 4. (The office staff were convenient babysitters). When I became old enough to help out (by filing charts or stamping them with dates), my father would often invite me in to his consultation room to introduce me to grateful patients who were more than happy to share their stories or allow me to view their healing eye conditions (my dad was an ophthalmologist, an eye surgeon). My dad loved his work, and enjoyed his daily interaction with his patients. Sometimes, he would call me in just to have a patient retell the joke that she had just shared, or to introduce me to a valued member of our local community: the town librarian of 50 years; the former fire chief; or the nurse supervisor of the local hospital's operating room. He loved hearing their stories and it was clear they loved the extra attention and interest he showed in them. To him, they were more than just eye conditions, they were "whole people" who just happened to have an eye condition... and he loved caring for them. My grandfather, a family doctor for more than 60 years, was most proud of his opportunity to care for several generations of family members. I will never forget him telling me on the cusp of starting medical school that he knew I would become a good doctor because I had "a good mind....and even more importantly, a good heart".

So, I followed my grandfather's footsteps into primary care medicine, then pursued additional training in psychosomatic and behavioral medicine, and subsequently psychiatry. I embarked on an academic career, inspired by my mentors at the University of Rochester, which is known for it's focus on the "biopsychosocial model" and the importance of strong training in interpersonal and communication skills. I have been very fortunate during my career to have had many opportunities to teach communication skills to medical students, residents and practicing clinicians and my current job includes a heavy emphasis on developing and implementing training and other strategies to improve clinician-patient communication.

And, despite some progress in recent years, there is great need for improvement in clinicians' communication skills. The evidence for this comes from not only a large body of research in clinician-patient communication, but also from my personal experience as a patient, from your stories on this list, and from the stories of many, many other patients and caregivers.

The good news is that we, as patients, can take steps to improve the communication process, steps that will increase our participation in care, help us to make good health care decisions, and ultimately improve the quality of our lives. This will be the focus of subsequent posts to this column, which will include links to resources, tools and other useful information on this topic. I also hope you will contribute your thoughts, ideas and experiences. Tell us what has worked for you and your family members and where you see opportunities for improvement. We will all benefit if we share "best practices".

With best wishes,


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