Treating patients with respect can not only contribute to their peace of mind, but also improve health outcomes, according to Dr. Susan Wehry.
Wehry, a geriatric psychiatrist, gave a talk about person-centered health care at the Vermont Veteran's Home on Tuesday. The talk was the fourth part of the home's Family Caregivers Series, which is put on in conjunction with the Vermont Chapter of the Alzheimer's Association, and the Governor's Commission on Alzheimer's Disease and Related Dementias.
"In a very interesting pilot program, it turns out shifting to person-controlled care not only makes them feel better, but the clinical results are better as well," Wehry said. Wehry said modern health care had strayed from its roots, becoming focused on the wrong things.
"I'm trying to help bring young physicians back to patient-centered care and away from disease-centered care," Wehry said. "To tell the truth, the center right now has become the disease." Wehry said, though, that the government department that funds Medicare and Medicaid has begun pushing a more patient-centric approach.
"It's part of a culture change," Wehry said. "With regulation, care has been not so much about quality of life as quality of care."
"The real message is to not just be focused on 'a person with a problem,' but what it means to be a person," Wehry added. Wehry said patients should be allowed to make choices,
even ones that might not be the best for them, especially if the choices can be accommodated without too much trouble.
"We're hardwired to feel good when we succeed -- when we wake up and say we want toast, we feel better when we get toast," Wehry said. "The issue about choices is not whether they're bad or good, but the consequences of them."
Wehry said the health care system had become too corporate and focused on drugs. "When health care became a business, there was less attention paid to the aspects of health within our control," Wehry said. "There's no profit to be made from someone taking a walk."
She said that, by changing the doctor-patient relationship to one of caregiver and consumer, a critical part of health care had been lost. "I'm a healer, not a dealer," Wehry said. "So much of what we've done in health care has driven away the primacy of relationships." Wehry said high-tech treatments were not always the best way to go. "Most people with pain and suffering, like those who suffer from Alzheimer's, need and benefit more from high-touch than high-tech care," Wehry said.
Wehry said the current long-term care system could be adding to patients' problems. "I am very concerned that, in the long-term environment, we could be contributing to excess disability," Wehry said.
Wehry said, though, that she was concerned the move to patient-based care could become too regulatory in nature. "I'm afraid person-based care could become a checklist," Wehry said. "That's what happens every time we regulate these things -- it becomes about forms."
Wehry said the reasons behind patient-based methodology were more important than the methods themselves. "It's not just about getting a patient's life story just to get the life story," Wehry said. "It's so, when we look at a patient, we see Mr. Joe, and not Mr. Joe with Alzheimer's Disease." Wehry said doing such things can cut down the extremely high rate of turnover at long-term care facilities, and could even end up saving money. To see more of the Bennington Banner or to subscribe to the newspaper, go to http://www.benningtonbanner.com. Copyright (c) 2008, Bennington Banner, Vt. Distributed by McClatchy-Tribune Information Services. For reprints, email tmsreprints@permissionsgroup.com, call 800-374-7985 or 847-635-6550, send a fax to 847-635-6968, or write to The Permissions Group Inc., 1247 Milwaukee Ave., Suite 303, Glenview, IL 60025, USA.
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