Person centred care and realistic medicine?
A letter to your best and worst healthcare professional
It's 22 years ago this week that my father died of cancer as I had just finished active treatment for breast cancer. Over that time we saw the best and worst in healthcare professionals. What was most stark was the poor care he had in a urology ward was the opposite of the care he had in the palliative care ward. The cultures couldn't have been more different. The palliative care ward saw all of us as recipients of their truly compassionate care. His needs were explored with him and us, they were anticipated and he died peacefully with his family around him. In contrast the other ward had failed to ask him what mattered to him, discharged him without preparation or discussion resulting in an avoidable fall and extreme pain.
What's most interesting is they were separated by a set of double doors and completely different cultures. What was the norm in palliative care was completely different in an acute service. This experience is what took me into health advocacy and I'd love to say it's very different now but there's still a long way to go too often. However as I have documented in this blog before I've had excellent surgical care and been treated with real compassion and that helps so much. But a key question for me is do I feel a partner in my care? The truth is that's depends very much on the individual Im dealing with. The process of the multidisciplinary meeting for breast cancer patients as a means to plan care and treatment has always been seen as the gold standard of care. But there's a key person missing; it's me. If we are truly to practice person-centred care and also realistic medicine then the i need to be at that table.
So for me it's less about individuals as they can change with the right support often; the real issue is the system and the culture.