Relationship-centered care can fix a broken system


170310 Fierce-Healthcare-Hospital-Impact


Originally published by FierceHealthcare


Since writing the blog post Continuity leads to relationship, trust and better care so long ago, I remain amazed at the extraordinary number of people who continue to share similar stories with me. Their stories.

In fact, a good friend of mine, who happens to also be a healthcare quality leader, said a recent healthcare experience really showed her how poor continuity and a lack of relationship can compromise care. Can hurt. Can harm. Can instill dis-trust.

She had recently booked her routine office exam, and in doing so was informed she could not see her regular physician but rather she would be seeing another physician who is part of the same care team. (An example of an unintended consequence of a team based model of care – disrupting care continuity). She decided to take the appointment and was soon in for her visit.

As part of her exam they performed an EKG. The doctor looked at her results and appeared puzzled. The unfamiliar doctor apparently saw some things that concerned him but eventually said stoically …

You’re fine. No problem.

My friend, being a nurse and working in healthcare quality, responded that she wanted to hear and see what was initially concerning, as well as discuss why the doctor did not believe there was a problem.

The response …

There is no problem. You’re fine. Good day. [And off he went.]

My friend was aghast. “Is this healthcare?” “Is this caring?” “Why can’t we have a discussion – bilateral communication?” “Why do I feel worse after my visit?”

She went home straightaway and told her husband that they were both going to leave this physician practice and find their former doctor — the one that knew them both and who they trusted (albeit the one whose office is now a good distance away).

“Rotating physicians who have little relationship and minimal time with patients — physicians who don’t truly know their patients — are not how best to help people,” she shared with me.

She did eventually get in to see HER doctor (the one that knew her and her husband) and with ample time, their historic relationship, and an opportunity to share fears and concerns (and feel truly listened to) did receive confirmation that indeed her EKG was fine and there was nothing to worry about.

“Healthcare the way it should be!” she concluded. “He listened. He leaned in. He created a safe place. He cared. And he showed that he did in how he communicated and through his actions.”

The way it should be … yes … but clearly not the norm in our broken healthcare system.

As  noted in a his blog post, “continuity of care starts with caring.” Yes … caring. And yet in speaking recently with another healthcare leader (with great influence in the community) I found that even though this leader logically understood and acknowledged the importance of these aspects of healing (and could even share his own stories translating the importance of time, relationship, listening, trust, empathy — caring — into the healthcare model) in his eyes is not yet “practical” and may not provide “longitudinal financial success” to healthcare organizations.

Now, I truly understand that there is a wide-variety of solutions to our broken healthcare model. And I also believe that one size does not necessarily fit all. But again, the foundation of healthcare is CARE. In fact, real healthcare is actually healthCARING. Time, relationship, listening, trust, and empathy are all key components of caring and stated as such in the Hippocratic Oath.

So, again, it still amazes me how important these aspects are to healing AND how consistently the healthcare system considers them impractical or worse, sets them aside to ensure “longitudinal financial success”.

To continue to sacrifice the health of our friends, families and communities for “longitudinal financial success” is appalling and highlights another side of a sick system.

It is time to heal the sick system.

It is time for mission-driven leadership.

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