As I was driving the car, on the radio station was CBC Ideas and the person giving the talk was Dr. Atul Gawande from Havard School of Medicine (and a whole host of other things) at the BBC Reith Lecture on the Future of Medicine.  It was a wonderful talk and could help make medicine better, but this post will concentrate on one part of the lecture. Dr. Gawande talked about the time in life when doctors are not really positive what to do or the next step. The example was a patient who had experience cancer treatments successfully and after a few years the cancer came back. What should the medical profession do? There are two choices try something new or do nothing, but lower the pain levels. Dr. Gawande pondered the choices, the patient was a friend which made it harder and still did not know what to do. As a writer he did research asking people in the end of life medical care and eventually came to the solution.

All people have priorities in the their lives beside to live longer. What does the patient want?

The most reliable way to learn what the patient wants is ASK.

As a general rule, doctors are lousy at asking.  Doctors are wonderful at giving you data and talking 90% of the time. If you are going to ask the patient, talk 50%.

Four questions to ask the patient to truly understand their priorities.

1. What is your understanding of where you are?

2. What are your fears or worries?

3. What goals do your have?

4. What outcomes are unacceptable?

With those 4 questions, very simple ones, the person knows what you want and equally what you do not want. As conditions change the answers can be updated. However with the patient’s priorities known both the medical profession, family and caregivers can be satisfied with the outcomes as well as the next steps.

In the above example, the patient wanted to finish off her time at home, in hospice care as well as be able to finish her piano teaching, which was her second love, her husband being the first. This was done and the storybook ending happened.

Linking to dividend paying stocks, at this time of the year all companies update their know the client are those 4 questions answered in your statement? If they are that is great, but the ones that the writer has seen many of them could be done better.

There are more questions than answers, till the next time – to raising questions