Palliative Care Equals Good Doctor

In “Good Palliative Care, Bad Palliative Care: A tale of 2 Doctors”, Marie Colantoni Pechet, a Stage 4 colorectal cancer patient, speaks about her extensive history with palliative care doctors and pain management.  Here’s our synopsis and point of view on this recent article featured on WBUR’s Common Health.

Marie discusses a particular bout of pain that turned her onto pain medication. Despite her illness, Marie was weary of drugs and rarely used them because of a fear of dependency, the inability to drive, a dulled communication in her body, and stomach issues.

Although she expressed her fears of medication, her palliative care specialist immediately pushed her onto narcotics. She was scared and confused at the sudden, suggested change.

Because of a plethora of reasons, she held off on filling the prescription and met with her regular palliative care doctor. She said that she immediately felt more comfortable in an environment where she could talk about her fears and feelings.

Instead of forcing the narcotics on Marie, the doctor explained the prescription and assured her of her fears. Marie wrote that after the meeting she felt so much better once she was listened and talked to.

This article conveys the obvious. Which, those of us in healthcare can sometimes be pressured to set aside with our intense workloads and over-booked schedules.  We cannot forget the importance of effective communication and listening from the heart.  Although both specialists recommended the same prescription, Marie felt much more comfortable with a caregiver who could patiently listen to her concerns and explain everything. Educating ourselves to make compassionate communication a priority is key to any treatment plan and at the core of our relationships with those we serve.

How does your organization support the practice of compassionate communication? How do you balance a high-volume workload with being a compassionate listener?

So, Now What do we do?

Unfortunately, the situation described above is not an uncommon one in our fast-paced healthcare system. Far too many times busy healthcare professionals can be a little inconsiderate of patient’s needs in an attempt to get to the next patient. As a result, the caregiver-patient relationship suffers and patients become further jaded about the healthcare system.

Palliative care’s ultimate goal is to relieve the emotional, mental, and physical suffering of the patient and their family. Without a trusting relationship between the professional and the patient, palliative care fails. It’s important to have open communication in order to effectively inform the patient of all of their options and possibilities so they can make the best decision for themselves and their family.

Although medication may have been the best treatment option for Marie all along, she didn’t feel comfortable with the decision until all of her questions, concerns, and needs were attended to. Palliative care specialists have the ability to transform suffering and worry into comfort and security through more effective communication. Sometimes a patient just needs a good listening to.

Healthcare careers are often thankless and stressful but it makes a world of a difference to a patient when they feel comfortable and prepared for the journey they are about to begin. Educating social workers, nurses, chaplains, and other healthcare professionals on delivering the best possible care is vital to both patients and society.

Here are a few things that our patients want us to remember about palliative care to avoid becoming the “bad doctor” that Marie encountered:

1. Communication
   1. We’ve said it again and again: communication is key when delivering good palliative care. A patient can only feel comfortable when there is an open and honest dialogue and they are aware of all their options. Palliative care IS compassionate communication.
2. Palliative care addresses all aspects of care
   1. Palliative care focuses on treating the mental, emotional, spiritual, and physical components of suffering. That is why we education is so important to everyone on the palliative care team. Effective communication between team members is the key to palliative care success.
3. Palliative care is centered around quality of life
   1. It’s important to remember that the ultimate goal of palliative care is to reduce suffering and improve a person’s quality of life. Active listening allows us to discover what the patient says is important in their life. That’s really, all that matters.
4. Palliative care is not hospice
   1. While hospice and palliative care tend to go together, it’s important to remember that palliative care begins at point of diagnosis. Patients may still be frightened by the words palliative care, and that’s wrong. We need to work together to teach our co-workers and patients that palliative care is not hospice.
5. It’s never too early to begin palliative care treatment
   1. Palliative care is more effective the longer it is given. It’s important to give support and comfort to a patient as soon as possible so they have the treatment and quality of life they deserve.

Comfort and quality of life are of utmost importance and it all starts with compassionate and effective communication.

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