Thursday, September 24, 2009

A Need for Change: Insights From a Patient

I am a young cancer patient, who has been afforded an unparalleled opportunity to gain insight into a flawed healthcare delivery system. I hope to share observations and opinions I have formed over my many months of treatment.

Once a month, I visit my oncologist's office to check on the status of my illness and to make changes to my treatment regimen, as needed. With 3-4 decades to spare, I am always the youngest patient at the clinic
. With a few outdated magazines and week old newspapers in the waiting room, I often am more amused by patients walking in and out rather than the provided "entertainment." It didn't take too long to notice a startling trend amongst the other patients. While my visits often ran around 30 minutes in length, other patients were ushered in and out as if they were whirling around a revolving door. At first I didn't think too much about it. I figured these patients had probably been longterm patients and the checkups became efficient and mundane for them. After a few months of visits and becoming what I would consider a longterm patient, my visits still lasted around half an hour...

In the dimly-lit and bare-walled waiting area, I began to theorize about my interesting observation. Was my situation so dire that I required extra long visits? Did the physician enjoy chatting me up compared to his other patients? Did the schedule just happen to dictate more free time around my visits?

Then IT hit me. The clinic has a strict rule against allowing patients to bring their families into the room, unless physical incapacities necessitate it. In addition, most of the older patients speak minimal to no English, as they bared with the physician's inadequate Chinese speaking skills. I, on the other hand, speak fluent English and have a solid background in science. While other patients fail to grasp what the physician is saying, not to mention their inability to understand the scientific concepts behind their illness and therapies, I always prepare a list of questions and studied my illness and therapeutic regimen carefully. Because other patients had a weak understanding of what the physician had to say, I can imagine many of them resigning to sitting quietly, waiting for the physician to conclude the visit. Not only is this an alarming trend, it is also a dangerous one. Many chemotherapy medications have strict schedules and narrow therapeutic ranges. One misstep can absolutely be fatal. In addition, these patients are not receiving the quality of care they deserve in battling such a grim illness. Understanding of the illness and therapies is unquestionably critical to a successful recovery.

This observtion has further validated my rallying call for more culturally-competent, multi-lingual health professionals. Above actual treatment, communication is key to successful healthcare delivery and successful patient recovery. While many of us strive to improve healthcare, we must not lose sight of simple things. We must be vigilant of a patient's right to know, which may necessitate the services of an interpreter. There remains a glaring need for better communication in the healthcare system. We must always remember this.

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