On my drive to Denver yesterday, after leaving Telluride, I thought much about our Telluride experience this week…as Tanya noted, it was an awesome experience. You students are smart, savvy, passionate, caring, curious, continuous learners, empathetic, with a wide variety of life experiences.
I want to reflect again the thoughts I shared when Wendy and I talked about Shared Decision Making on Wednesday afternoon, when y’all really got into your SDM role playing:
–It’s very PRACTICAL to include and engage the patient/family in clinical options and discussion — though some physicians have done this for a long time.
–The patient/family need to FEEL INVOLVED.
–Traditionally, we have a WELL INTENTIONED DOCTOR making/guiding the decision, w the patient not actively involved…too often this interaction has been condescending.
–Suggest a LOVED ONE also be involved, in addition to patient, as much as possible, just as 24/7 in the hospital.
–This SDM engagement can include an element of NEGOTIATION, per Paul’s presentation, agree on underlying interests, then pursue options.
–SDM can reduce RESENTMENT toward physicians that some patients unfortunately feel — we learn more about our doctor…her/his skills, experience and trust level
–At the heart of this is LISTENING AND RESPECT, necessary to functioning as a PARTNERSHIP AND A TEAM.
— Likewise, MINDFULNESS, with a focus on the patient and their interests as they verbally express them
–EYE CONTACT is always important, not just talking/listening while typing into the EHR.
–Can frequently LEARN MORE ABOUT the patient than just the current clinical issue, as to how a specific issue fits into her/his overall health plans/goals.
–Lastly, a very key principle: “NOTHING ABOUT ME WITHOUT ME” — from Margaret Murphy, a long time advocate from Ireland — this is important even when the patient and doctor are in the same room, talking with each other.
Don’t ever forget your TRUE North…you will be challenged in various clinical and life vignettes/decisions…stick to your values and what you know to be right.
I wish each of you many blessings as you continue to pursue your clinical careers and life journey! As noted yesterday, I would be pleased to stay in touch.