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‘Patient Revolution’ begins at Cafe Steam

December 20, 2017 GMT

As a researcher, Victor Montori published hundreds of studies about patient care with his team. But he didn’t see any change in the way the health-care system was run until he joined the revolution.

The intersection between patient care and the needs of physicians was the topic at a Patient Revolution panel in Cafe Steam on Monday evening.

The Patient Revolution is a nonprofit organization that emphasized “careful and kind” hospital care and a patient-focused health-care system, which stemmed from Montori’s research.

Montori, a researcher in the Knowledge and Evaluation Research Unit at Mayo Clinic, read from his book, ” Why We Revolt: A Patient Revolution for Careful and Kind Care, ” which he wrote to encourage other members of the “patient revolution.”

The “patient revolution” must take the focus away from putting people through the system of health care and instead emphasize practices that fit the needs of the patient exactly, he said.

He was joined by Monika Duitch, who works in cardiology and care at Mayo, and Paul John Scott, a health journalist who previously wrote for the Post Bulletin.

Patient at the center

Montori wrote “Why We Revolt” to guide and encourage “patient revolutionaries” who will “demand and achieve health care for all.”

Scott said health-care discussions usually focus on one of two issues — increasing technology in or broadening access to health care.

“Why We Revolt” posed a third question, he said: “What is going on in health care, and why does it ask so much from a patient?”

When Duitch is a patient and she sees a sign on the wall that says, “We can only manage two primary concerns per visit,” she feels frustrated, she said.

“If you know me, you know I have at least a hundred,” she said.

Earlier this year, Duitch experienced health care as a patient when she was hospitalized.

“What I saw was nurses who spent time at the bedside with me, residents and doctors who took time out of their rounds to answer questions, and came back at the end of the day to answer more,” she said. “Those things were so important to me.”

Shift in thinking

As a practitioner, she was well aware of everything going on behind the scenes — endless charting, data entry and hundreds of other patients demanding attention.

The book, however, articulated many of her concerns as a patient and practitioner.

“It starts a conversation and it give you the tools, both as a patient and a clinician, to move toward something more positive,” she said.

“Innovation added years to my mother’s life, but I also wonder if we get stuck in traps and think the thing that’s going to save medicine is the next big discovery,” Scott said. “But what if it’s what Victor is talking about … a shift in thinking?”

Electronic medical records and data charting are useful, Duitch agreed, but they aren’t everything.

“I think things go wrong when they take you away from the patient,” she said.

Seen without being seen

Part of the book’s goal is to articulate the changes in health care or the ways patients can feel failed, Montori said — like “blur” — the idea that a person has gone through a health-care visit or procedure without really being seen by their clinician.

Burnout, another issue discussed, can happen when physicians can’t reconcile their mission (helping people) with their daily tasks (navigating new rules), he said.

The timing of the book is particularly profound, as DMC preparations continue, Scott said.

“We are starting to wonder how to transform the health-care system as all these buildings go up,” he said. “It’s more than building.”

Starting a #PatientRevolution could harness that same force, Duitch said, by asking patients to share stories of the ways the health-care system has either failed or supported them.

She modeled the potential movement after the #MeToo movement against sexual assault. Care that treats people like a number is unacceptable, Montori said. Breaking down tolerance is the first step, but there must also be a social revolution, he said.

“The movement not only is for patients, but we think it’s going to be done by citizens,” he said. “As we pursue caring and kind health care, we should find not only patients, but students … hospital workers and social workers, physicians, nurses, nurse practitioners who find that the system stopped caring for patients, but stopped caring for the front lines.”