Re-evaluating patient interactions: Keys to providing top-rate treatment
Although a new patient with cancer is not likely prepared to hear the devastating diagnosis, preparation is what will carry him or her from initial consultations through to every treatment. Preparation is the responsibility of the physician and the health care team, and it is their job to communicate the benefits of preparedness to provide the best quality of care.
Effective communication should be a priority to any provider, yet it sometimes may be lost to an overbooked schedule in an active practice.
Identifying the problem
In an extreme scenario, a woman may receive a lymphoma diagnosis from her primary care physician, who then refers her to an unfamiliar hematology/oncology specialist. The patient arrives alone to the consultation, and because the physician has a limited amount of time allotted for the appointment, he or she rushes through the consult. That leaves the patient unaware of what to expect at treatment, which only serves to deepen her fear.
It is striking that rushed appointments may occur with some regularity. Health care professionals treat patients who have cancer every day, yet each patient is likely experiencing this diagnosis for the first time. These trends of inadequate communication have prompted the oncology mental health community to take action. Cancer Support Community (CSC), an international nonprofit that provides support, education and hope to people affected by cancer, and Cephalon Inc. commissioned Harris Interactive to conduct an online survey in summer 2010 to pinpoint the communication breakdown between patients and health care providers.1 The survey was taken by 150 hematologists and oncologists, as well as 133 patients with indolent non-Hodgkin’s lymphoma.
Although results showed several areas of congruency between patients and providers, there are still critical areas in need of attention. For instance, health care providers are accustomed to addressing patients’ top-level concerns after a cancer diagnosis, such as the potential loss of life and side effects from treatments. However, what is most likely not discussed are the ramifications of a cancer diagnosis that have a ripple effect in the patient’s life, including the patient’s concern about family, the ability to stay employed and the likelihood of financial distress. According to the survey, 51% of patients worried about the impact of the disease on their families, but only 22% of physicians recognized this as a relevant patient concern.
A new frame of mind
The survey results prompted CSC to develop Framing Life with Lymphoma to provide useful tips to patients and to offer information to health care professionals about guiding patients through the communication process throughout the cancer care continuum.
I find that programs such as Framing Life With Lymphoma provide valuable information for patients. Tips range from writing down all questions and responses and reporting all side effects, to engaging a support system of family, friends and professional counselors.
The program also is a reminder to physicians to occasionally re-evaluate initial consultations, thereby remaining focused and dedicated to every patient. I recommend physicians be mindful of what they would like to accomplish during each appointment, including a discussion of the diagnosis and the disease itself, treatment options and prognosis, then answering any questions, all while using language patients will understand.
Helping patients prepare for consultations and treatment can maximize the physician’s time to explore the particular nature of a patient’s lymphoma, to identify appropriate treatments and to answer all questions. It is important that the information patients receive is as complete as possible, allowing them to take the time necessary to come to terms with their diagnosis, digest the information and become an integral part of the treatment team.
- Framing Life with Lymphoma survey fact sheet. Cancer Support Community. http://www.cancersupportcommunity.org/MainMenu/About-Cancer/Types-of-Cancer/Non-Hodgkin/Framing-Life-with-Lymphoma/National-Survey-Results.pdf. Accessed Oct. 12, 2011.
David H. Henry, MD, is a community oncologist and clinical professor of medicine at Pennsylvania Hospital in Philadelphia. Disclosure: Dr. Henry is a paid consultant for Cephalon Inc.