Thursday, June 13, 2019

Getting To Know You

Image result for doctor and patientEnvironmental & Science Education
Edward Hessler

You wanna' go where everybody knows your name.--Cheers Theme

What a difference a small change in practice can make for both patients and attending physicians.

Surgeon Dr. Benjamin Schwartz is a gynecologic cancer specialist. He and his team made a seemingly small change in how they prepare for surgery and it "has forever changed the way we now practice medicine."

The idea occurred when Schwatrz was being mentored about his two decade career by another physician who revealed that he had prostate cancer. He told Schwartz that his doctor "had asked to meet with him and his family, and then asked the family members if he could email them."  He wanted them to tell him "stories about the patient--his likes and dislikes, what made him special, and other information that would help his caregivers know and relate to the person behind the prostate cancer diagnosis."  It had a positive effect on him and his family.

So Schwartz "followed suit." He told a patient what he had in mind and then asked the patient's permission to email family members. In the first case, the patient's husband mentioned that his wife was a Pink Floyd fan. So when the patient entered the surgical suite Pink Floyd's Comfortably Numb was being played. The next patient was a member of a gospel choir in her church and was greeted with gospel music.

Schwarz's team wondered why the music was being changed and he "explained how it wasn't about the music but making a human connection." The team wanted to know about the emails and "wanted to read them too." The team's standard practice had been to approach a surgery by taking "a pre-surgical pause to prepare before the patient entered the operating room. It's a scripted process in which we discuss important elements of the case." 

In hospital talk patients are often referred to not by name during discussions but as "the cervical cancer patient in Room 303." Schwarz writes that after the change in practice "we know who they are."

"In a recent case, Daniel, a patient's 13-year-old grandson, wrote about his grandma's special meatballs at their Sunday dinners and how he was terrified he'd never see her again or have her be part of those special dinners. 'Please do your best today.'" Schwartz said what you would expect: it "resulted in a hyper-sense of focus."      

You may read Schwartz's full essay in STAT. I hope you will. 

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