Truly patient-centered

“Patient-centeredness establishes a partnership among practitioners, patients, and their families (when appropriate) to ensure that decisions respect patients’ wants, needs, and preferences and that patients have the education and support they require to make decisions and participate in their own care.”

Institute of Medicine

Envisioning a National Healthcare Equality Report

What is “respect?”  What does that word mean? 

 It makes me think of the twin concepts of “rights” and “responsibilities” and how they work together.  Patients always have “right of refusal,” for instance, and I honor that- but it is necessary- mandatory, I should say- that it be informed refusal.  It becomes my responsibility to inform the person of risks and benefits of possible choices, and the patient’s responsibility to make an informed choice.  At times I find myself in the role of “translator” from more technical medical language into words closer to a person’s typical vocabulary, something I enjoy greatly (as a nurse and a lover of language in all its forms).

The reasons for refusal can be surprising.  With open communication, these can be discussed openly, and new possibilities found– and that is a part of my nursing role too- to relay these to the physician, in order to find the solution most acceptable to the patient.  We’re working as a team.

 

More information about the seven core features of a patient-centered medical home can be found here.

Not really new at all

I mentioned my ”new role”  focused on the PCMH (Patient-Centered Medical Home) model of care.  It’s not truly new to me- I’ve been doing similar things for some time, albeit on a smaller scale, in between helping treat acute illnesses or exacerbation of chronic illnesses.

 

But now that is becoming my entire work focus- helping people live healthier lives, problem-solve through personal barriers, and seeing them feel better during the process.

 

I have had some success emailing patients, too, and seeing blood sugars gradually come into a healthier range- and people noting that they do, indeed, feel better-  has been most gratifying.

 

I have also had some frustrations and I would like to share some of those as well.

 

I promise I will never compromise patient confidentiality by posting identifying factors– because privacy is so important.  I hope to be inspiring, to problem-solve, and to share ideas with others who may be doing this, or thinking about doing this, at their own clinics.  I’ve always worked out problems by writing, and this seemed like the perfect forum to do so on.

PCMH Nurse

PCMH stands for “patient-centered medical home.”   It is a new concept that is actually an old concept: the idea that people each have a place where they receive person-centered care, a place that is like a “home” or home-base, if you will, where the person and his or her provider work as a team to set goals, and acheive those goals.

 

Except I missed an important piece in my definition above: nursing.

 

Allow me to explain: I got a new job yesterday.  Actually, I was chosen for a new role in my current job- with a hugely different focus than what healthcare has become in this country: people.  Individuals.  Families.  Wellness. 

Not medication, not technology: not that those things are bad.  They are useful tools.  But we have other tools: ideas.  Partnerships.  Caring.  Empathy.

 

Everything that has happened to me in my life has prepared me for this and I am ready to rock.

 

I work in Family Medicine.   Our specialty is not to specialize.  I believe in Family Medicine, and have always chosen Family Medicine physicians as my primary healthcare providers.  President Obama believes in Family Medicine too- he has just appointed a new surgeon general, Regina Benjamin, who is a primary care doctor.   Per the article- worth reading- “The administration pushes to reorient the health-care system toward prevention and primary care.”   Dr. Benjamin stated, when President Barack Obama introduced her Monday at the White House Rose Garden, “My hope, if confirmed as surgeon general, is to be America’s doctor, America’s family physician.”  Vindication!

 

So, to  anyone who may be reading this, I do apologize: the blog formatting needs work, and this first post is rather desultory.  I just wanted to celebrate by starting a new blog.

 

If you would like to know more, here is some further reading to get you started.