Wednesday, October 5, 2022
HomeHealth & FitnessWhole person care can make us better therapists

Whole person care can make us better therapists

I have deep war wounds on my face at a patient in a pain clinic at a military base in Virginia. Not physical scars, but sallow, flabby complexion and empty eyes of exhaustion and failure. An Afghan war veteran, he has long suffered from anxiety, depression and other complications of PTSD, although his main complaint is back pain.

Patient, I will be calling Sgt. Carlson to fill out my Personal Health Checklist (PHI) for all complex patients, the process used by the Veterans Health Administration, I find it very useful in starting a healing relationship and guiding them on their recovery journey. PHI includes the question: “What’s the most important thing in your life?”

“My Cat and my wife,” Sgt. Carlson wrote — in that order. “Tell me more,” I said. Come calm me down,” he said. “My wife is my best friend and she helps me stay up late, but she works most of the time. “

This conversation that changed his course of therapy might never have happened had I not changed my practice to embrace Whole Person Care. I started talking and listening differently My patients, then ask broader questions than just focusing on the main complaint.

I’m seeking to explore Sergeant’s issues. Carlson’s life extends far beyond the confines of my office “But that’s clearly what made him sick. He doesn’t need to change his medication. Instead, he needs a complete partner who can help him find his way on his sometimes confusing journey from sickness to health.”

My lifelong pursuit of becoming a therapist – a family of physicians, scientists for over 40 years at the National Institutes of Health, World Health Organization, Walter Reed Army Research Institute and Department of Defense And the researcher – which led me to the conclusion that the best way to build the strongest and most effective doctor – patient partnership is not to limit my questions to “what’s wrong with you?

Instead, we must try to get to the root of the patient’s health and well-being goals by asking the following questions: “In your life? “

Like countless doctors, I have struggled with depression and burnout for years. I need to connect more deeply with my patients, but I don’t have much training, time, or support to Do it. So, I restructured my office visits to reframe the patient (and my) experience from one focused on diagnosing and treating disease to one focused on personalizing care and emphasizing prevention, health promotion, and self-care The experience. I switched from just focusing on therapy to learning how to support the recovery process.

This transition brought me back to the core of what I started as a doctor.

As new doctors, we were trained to write SOAP instructions (subjective, objective, assessment, and plan) to describe a patient’s condition and course of treatment. But research shows that medical care itself accounts for only about 20% of health and recovery. Nearly 80 % come from other factors that are rarely addressed by our system. These are emotional and mental health, behavior and lifestyle, and the social and economic environment in which a person lives – these factors are rarely reflected in SOAP instructions.

I took a “whole person care” approach to my patients. This included having the patient complete a health questionnaire on the social determinants of the patient’s health. I learned from this questionnaire and interviews with the patient The insights gained gave me a more holistic view of their lives, put the patient at the center of their care plan. Most importantly, it sparked the patient’s intuition about what they needed most.

This allows me to provide them with whole person care coaching, group visits, nutrition counseling, acupuncture, yoga, meditation, therapeutic massage, stress reduction that combine traditional medicine with evidence-based complementary modalities such as wellness and other non-pharmacological methods.

In Sgt. Carlson’s case, our visit gave him a new orientation involving personal journaling, peer group counseling, etc. His path remains Tough, but he was infused with new energy and motivation. Learning from patients like him, I developed a more rewarding practice that relies less on pills and procedures and more on listening and therapy.

It’s also important to understand that this is not a pie in the sky. For example, the Veterans Administration has made great strides in transforming its care model from a traditional disease-based transactional system to a team-based, person-centred model of care Significant results, the model is designed to address the physical, emotional and social well-being of patients. In their 4-year pilot program with 130,000 veterans at 18 locations, the VA reported improved outcomes, patient experience ratings, and significant savings 20%, or nearly $4,500 per veteran per year.

While the VA is seeking massive change, the transition to holistic care is available at all levels of care .While health is largely determined by factors outside the healthcare system, we can still provide tools , team, and most importantly, provide language to guide patients on the road to recovery.

It starts by really putting the patient at the center of everything, asking them what is important and supporting them in addressing the determinants of health.

Wayne B. Jonas , MD, is a family physician.

This article appeared in KevinMD.



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