COMMENTARY

'Take a Patient Home': It's Eye-Opening

Henry Anhalt, DO

Disclosures

July 25, 2018

Editorial Collaboration

Medscape &

As a pediatric endocrinologist, I had very little insight into what it is like to care for people living with diabetes. I trained in a place where that was not necessarily emphasized. We did not have much to offer, except for insulin. Fortunately, today there is a lot of advocacy and voices are being heard from the diabetes community. Self-advocacy is moving the needle on self-care.

I think what drove home for me how unavailable service is for people living with diabetes came from my experience working in the inner city. It was there that I recognized how challenging it is to take care of diabetes in childhood. The management burden falls upon the patient. Without appropriate services and access, often these patients do not do as well as they could.

Many patients would like to participate in clinical trials but they may not be aware of them, or they may live too far from a medical center where trials are being done. Fortunately, we are seeing a rise of decentralized and virtual trials—these may be the only point of contact that patients have with the healthcare system. As we continue to see decentralized trials grow, I think this will bring a whole new dimension to how patients interact, not only in clinical research but in their own healthcare.

One of my most important realizations for what it is like to live with a chronic disease came when I invited a patient living with diabetes to my home. Now, before you think that I am saying that you should go into a clinic and just offer to take somebody home, this is someone that I diagnosed at the age of 4, and I knew the parents very well because I was a classmate of her father's.

When she visited my home, I realized all of the steps that she needed to take—even though I'm a provider. I realized what it was like in real time to live with the disease. The conversation I had with her parents prior to her coming to my home stressed them out because a lot of preparation was involved. They had to communicate about what she liked to do and what were the possible impacts on her blood sugars. Even though I was a seasoned endocrinologist who cared for people living with the disease, having that patient in my home raised my level of compassion and understanding for what it is like to live with a chronic disease.

We as clinicians come to the understanding—sometimes sooner, sometimes later—that our patients need to feel safe. They need psychological safety to be able to raise concerns that bother them.

We have all experienced when patients are not telling us what they are feeling. Why is that? To some degree, it is motivated by our desire to see them have great outcomes. But many times they feel judged or not listened to.

As we continue to mature as physicians and expand our practices, keep in mind the power of listening and that the impact our words have on people living with the disease is really important. If we become just a bit more sensitized to listening and how patients feel when we communicate with them, we will all see better outcomes.

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