"Our intervention-oriented medical culture doesn't produce humane care."
This opening sentence from a Health Affairs article recently caught my attention. The article, written by physician Muriel Gillick, examined how the technology-oriented medical culture at one teaching hospital led to patient overtreatment.
Dr. Gillick's story about an elderly patient was all too familiar: her patient, suffering from multiple chronic conditions, had recently developed an acute illness and begun to deteriorate. Dr. Gillick suggested a less aggressive approach given the patient's advanced age and chronic health problems; however, the patient's family and regular physician decided to pursue a more extensive treatment plan. Months of aggressive medical treatment didn't change the patient's clinical outcome but did result in increased patient suffering and increased medical costs.
So how can we provide appropriate clinical care that minimizes patient suffering? I think Maureen Bisognano, president & CEO of the Institute for Health Improvement (IHI), may be on to something. A few weeks ago she discussed the concept of minimally disruptive medicine at a Schwartz Center symposium on compassionate healthcare. According to Dr. Victor Montori from the Mayo Clinic, minimally disruptive medicine seeks to provide clinical programs which consider the benefits and burdens of treatment on patients.
Yet clinicians should not assume that minimally disruptive medicine is about less care. On the contrary, it's about care that is more patient-centered. It's about making sure patients completely understand their treatment options and that physicians understand the care patients and their families expect, especially when it comes to end-of-life issues.
Ultimately, the balance between clinical benefits and burdens will be achieved through good communication and a strong partnership between patients and clinicians, not an overreliance on medical technology.
How do you work with patients to balance the benefits and burdens of treatment?
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2 comments:
yes, "the balance between clinical benefits and burdens will be achieved through good communication and a strong partnership between patients and clinicians, not an overreliance on medical technology." but in reality many doctors are not talking. they kept it to themselves. exploring new drugs and technology on the expense of patient and its family circles.
Hi Art,
Thanks for your comment. You make a good point. How do you think we can get clinicians to start talking?
Julie Rosen
Executive Director
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