ACOG- Shared Decision-making
Dr. Levy
Dr. Hurtado, um, how do you include your patients in the decision making process?
Dr. Hurtado
I try to first ask them, what is your goal? What do you want, um, to treat, uh, try to listen to what is their main concern? Because certainly as medical professionals, we, um, have the expertise to treat the disease process. And in the past we always tend to be disease focused, uh, where we want to solve the problem. We want to treat that anemia. We want to, um, reduce the size of the fibroids. We want to treat their symptoms, but it's important to listen to the patient and find out what is their, what do they want, what do they need? Do they need to be able to go back to work and not miss workdays? Um, do they want to have a child in six to 12 months? Uh, are they wanting to be able to get through the perimenopause and reach menopause without having to do surgery and control their heavy menstrual bleeding from their fibroids? Or are they looking to try to treat the symptoms, um, um, of their fibroids, whether they're having pressure or pain. So we need to listen to what they're looking for and then, um, be able to go through the different choices that we have, um, uh, available to us, both surgical and medical to help, um, uh, arrive at that goal with the patient. I think certainly what you mentioned before of sitting down and writing out a list of the different therapies, give them that information, um, what websites or pamphlets that, um, they can go further to, um, get more information after you've talked to them and bringing them back again, um, to discuss the issue. I think we, as clinicians need to also move forward to not only treating the disease, but treating the person, um, and, um, be aware that, um, health is not an absence of disease, but it is actually treating the whole person, both, um, physically, mentally, emotionally, and socially, um, achieving wellbeing, um, by this is one of the, our main goals that, um, I have in making sure that the patient, um, understands the different options that they have and making sure that I listen to them in terms of what they're looking for.
Dr. Levy Shared decision-making
Beautifully, beautifully said, thank you. You know, I think your key point there is that we're treating people and it's awfully difficult to treat the emotional, mental, social aspects if we don't know what they are. And so it's incumbent upon us to learn about those things by establishing a relationship with our patient, and that doesn't happen in one visit. It happens over time as she gains more trust in us and that we are truly her advocates. And I think, you know, we're missing that to some extent in, in the transactional kind of medicine, that a lot of us are having to practice these days and, and to manage something like heavy menstrual bleeding, uterine fibroids, many of the conditions that we deal with in gynecology, they're chronic they're long term. And they do really like really require a relationship to understand our patient well.
Dr. Bradley QoL
I would also agree. And I also often have said in my career that, um, a woman is more than the sum of her body parts. And, um, cause we had said that from head to toe, we have to take that woman's experience. And, and as I think about the last year with COVID for many women, maybe it's just by coincidence in the last few weeks, not that they wanted COVID, but they've been able to work from home and that they have been able to quote, deal with their periods much more with less absenteeism because they are working from home. So, um, you know, all of you, all of us, I think have really honed in on that patient centric care and, um, we do have to include them in the decision-making and try to make them informed with the options that they do have.
Dr. Kim Including family in decision-making
I think um I completely agree Dr. Bradley about, um, you know, with, uh, especially with the pandemic. Um, you know, I think a lot of our patients are, you know, at home, uh, doing the tele-health visits and, um, perhaps, you know, when they've had, um, in-person visits or procedures, you know, I think maybe family members were maybe more involved, but I think we have to just remember that even with telehealth visits, um, you know, we can include family if they wanted to, especially since, you know, they're also probably seen the effects, uh, from the effect that, that it's taking a toll on the patient herself.
