The Importance of the Doctor/Patient Relationship in Cancer Treatment

In Breast Cancer, Recent Posts by Barbara Jacoby

Several weeks ago, I wrote about treating the whole cancer patient and how this can only happen with an exceptional doctor/patient relationship. Therefore, I went back to the original source that I had consulted on this topic, Scott LePor, D.O., Medical Director of Patient Experience and Physician Engagement at Gordon Hospital in Calhoun, Georgia to obtain a better insight into how this might be accomplished. Fortunately, he was willing to outline the path that he and those on his team have taken in order to create the basis for the achievement of an enhanced doctor/patient relationship that results in better outcomes for the patient.

If you find that you are not being treated with the dignity and respect and shared decision-making from any member of your medical team, you just might want to find a replacement for the member who is not interacting with you on this level in your treatment. Barbara Jacoby

“This is a summary of what we are doing and the basic principles we are using to accomplish the improved patient experience. I think I have mentioned before that we are using the evidence based neuroscience of Trust Based Relational Intervention that was developed through the Institute for Child Development at Texas Christian University for foster and adoptive children in helping them heal from previous traumas through trust based relationships. These principles were developed through the wonderful research of Drs. David Cross and Karyn Purvis. The science is proving evident for any relationship and for all ages, including physician-patient relationships.

We started to implement these principles of Empowerment, Connection, and Correction through the medical directorship I have as well as Brendan Nieto, Associate Vice President and leader of the clinical medical group and his direction in managing the 24 clinics we have with well over 100 clinical providers including specialties. The medical directorship that I manage is set to improve patient satisfaction and that includes the whole patient experience from the time the patient pulls up to the building, checks in, waits, sees the provider and leaves. The physician engagement part is my involvement with individual physicians, MDs (allopathic physicians) and DOs (osteopathic physicians)) and making sure they are Empowered (have the tools they need to maximize their production and have the resources to meet the patient’s needs optimally for each and every visit),

Connected (maintaining a trust based relationship through mindful connections regularly interacting and addressing concerns that affect the patient’s visit as well as intimately sharing in personal settings (we are starting small group therapy/sharing sessions for our providers meeting quarterly) and then Correction (gently guiding behaviors or practices that are ineffective or potentially disruptive to a more positive approach or more efficient to improve the patient’s overall experience). It is important to note that the Correcting principle can only be accomplished effectively after a solid foundation has been established based on trust through implementing the Empowering and Connecting principles. It is also imperative that all three principles must be applied through careful mindfulness (being fully aware of the mental state, capacity, desires, and needs of the person you are interacting with as well as the mental state and being of yourself).

This approach leads to changed behavior patterns in how the physician then treats the patient as we then tend to see those principles start to be applied to the patient from the physician. Therefore, the physician starts to become more mindful of the patient’s mental state, capacity, desires, and needs, and with that mindfulness, he/she is more aware to effectively meet the patient’s needs, connect with them at a trust based level, and then gently guide more effective healthy behaviors as well as a targeted approach to their health care plan. These principles therefore give “voice” to the person being interacted with and allows the care plan to be based upon including the heartfelt wishes of that person.

This model is based upon high structure and high nurture, meaning that there are strong guidelines to what is safe and healthy but are always implemented through a shared relationship valuing the other person with love, gentleness, kindness, patience, and self-control. Interactions never include shaming, harming, or intimidating anyone. The current neuroscience from many different arenas is showing that the human being thrives in this type of relationship and can actually help improve the health of that person to thrive as well through healing disease and increasing longevity of life. It is also interesting to note that this model leads to decreasing physician burnout as well by improving their overall satisfaction by mindfully nurturing the providers overall well being mentally, physically, and spiritually.”

This is the doctor/patient relationship that I believe that everyone deserves, especially cancer patients who have a whole team of doctors with whom to deal from diagnosis to forever. And if you find that you are not being treated with the dignity and respect and shared decision-making from any member of your medical team, you just might want to find a replacement for the member who is not interacting with you on this level in your treatment. After all, it is your life that may very well be on the line and if you don’t expect and request such respect, you may not find that you are receiving the best care available to you.