June 29, 2016

Communication

We had the last of our community-day exercises for the second year last week. These are non-hospital days, where my clinical partner and I meet with a patient to discuss how they are managing in the community with a specific condition, diagnosis, or care package (or all three). Usually our discussions are very focused – for instance, we once met with a patient who was making use of hospice services. We also once met the parents of a child who was living with Down Syndrome and discussed with them all of the services that they are provided and how they make use of them.

These sessions are really useful, as they open our eyes to the services that our government and communities provide and show us all of the support that families can use. As someone who has led a relatively health-filled life, I’ve never had to make much use of these services – apart from the odd visit to the GP – and thus it’s always very useful and educational to see what else is out there. Health Visitors, District Nurses, physiotherapists, occupational therapists – just to name a few – all play a very important role in managing patient health, especially out in the community. And it’s so important for us to talk with these professionals as well to get an idea on how they can help our patients.

On our “recap” day, we get together with a few other clinical-partner pairs to present our cases and discuss any common themes that might come up across some or all of them. It’s interesting for several reasons. First, the different patients’ conditions are, of course, interesting by themselves. After spending so long in lectures and discussing people on paper, it’s really interesting to see them in real life. But more importantly (and fulfilling the purpose of our exercise), we are there to see how their packages of care fit together. Sometimes this works really well, and other times it doesn’t fit quite so nicely.

Communication (or lack thereof) was the one common theme that came up across all clinical-partner groups in our most recent meeting. Most patients and their families could not fault the quality of service nor the professionalism they received from each of their caregivers. And none had a bad word to say about the facilities. But what came up time and time again was the fact that, at least for these people, it simply didn’t seem joined up. Every time some of them saw a new doctor, they had to start from the beginning and explain their cases again. It seemed that either the letters were getting lost (or never sent) or, somehow, the communication train was breaking down a little too often for them.

This gave me a lot to think about – whilst, even as a practicing doctor, I expect to be little more than one cog in an enormous wheel most of the time, at least I am better equipped to understand where my patients are coming from should they be frustrated at the “system”. This portion of our education is very valuable. It cannot be taught from PowerPoint, nor even told from a hospital bed. Seeing these first-hand encounters really brings home for me what the entire patient experience is all about.

John


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