How one oncology practice helps patients handle bad news
"You have cancer." These three little words can make a big difference to a patient, causing first denial, then anger. Next come the thrashing doubts about prognosis, overwhelming decisions about treatment options, and fear -- lots and lots of fear.
No physician can guarantee everything will be all right; even coercing the illness into remission may be out of reach. But one oncology practice in Memphis is bound and determined to at least make the experience of cancer treatment as positive as it can be.
It all starts when C. Michael Jones, MD, clears his schedule for an hour and a half for each new patient. After they have a long, private talk, patients are escorted around the office and treated to a very detailed tour of the place. All the processes are explained. Most importantly, new patients are shown the equipment that will be used in their treatment, and urged to ask as many questions as they can come up with.
"Most of them have no idea what chemotherapy is about, and they've heard horror stories," says Jones, who launched his practice four years ago. "This gives them a chance to see what to expect, and to be more in control of it."
Getting to know you
During the tour, patients have a short chat with each of the 20 staff members. Administrative coordinator Cheryl Jones (Jones's wife) says all of this meeting and greeting may seem excessive -- but it's actually an important part of the process. Not all patients are going to bond with the doctor, or even a nurse at the practice. But it's integral to their experience that patients feel comfortable with someone in the practice.
Ensuring patients' comfort with the staff also has a utilitarian purpose. When insurance companies start causing problems, patients know who to see for help. And if they have questions about meds, they're already on a first-name basis with the in-house pharmacist, Ashley, for instance; they can just give her a ring.
Of course, staff members have to be carefully chosen. Jones says all employees need to have a calm demeanor, be stellar listeners, and above all, be cool with the prospect of comforting people who may not be alive in a few months.
After introductions, new patients are directed into the open treatment area. There, they see a roomful of patients hooked up to machines, yes -- but more often than not, laughing and gabbing with each other. This goes a long way toward de-stressing the newcomers.
"They quickly realize that they're not going to be isolated in some dark place," says Jones. "At first people think they're going to want to be by themselves during treatment. But when they see all the action, they want to be with the group. And that's better for them."
So much better that patients whose friendships have deepened often schedule their treatment times to coincide so they can hang out. "It's like a coffee klatsch in here when the iridium-group ladies show up," says Jones.
For their own good
To keep the office ambiance as warm and inviting as the relationships, patients get the chance to decorate, if they're into it. Jones says if a patient expresses interest, the practice hands out some cash, along with the offer to "go out and get us what you think we'd like." Thus, the place is now filled with comfy chairs and large, faux palm trees (the real kind is off-limits because of patients' various sensitivities).
Where did Jones get the idea to institute such a patient-centered practice? He won't name names, but says he's seen many oncology operations that treat patients coldly -- won't get to know them, and don't hear their concerns at a time when listening and relating are critical.
Oh yes, it gets expensive, all this extra attention and the special patient-education sessions. In fact, time patients don't spend directly with the doctor or having a treatment is not reimbursed at all.
It's not easy. But Jones says he's not giving up. "This is important. The patients need it."
Suz Redfearn can be reached via firstname.lastname@example.org.
This article originally appeared in the January/February 2002 issue of Physicians Practice.