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Displaying 1-2 out of 2 published
Recent news that Britain lags behind other countries in cancer survival rates http://www.bbc.co.uk/news/health-21242871 highlights the need for an integrated healthcare model to improve the way in which individuals with or at risk of such long term conditions are managed.
The research indicates that one of the reasons behind poor survival rates is late diagnosis, which is reported to be down to a patient’s reluctance to visit their GP due to a fear of time wasting or embarrassment. This is however, not the complete picture. It is equally as likely, if not more so, that individuals will not seek clinical advice because they have little or no idea of what the support networks are if they are diagnosed.
This fear means that it becomes all too easy for someone to incorrectly self-diagnose based on a previous experience or explain away what might be a telling symptom for a medically trained professional.
This is where health coaching can make a huge difference. For individuals diagnosed with a particular long-term condition, health coaching - where registered nurses help the patient manage their condition by providing mentoring and support via two-way phone calls - is emerging as a powerful platform to nurture informed patients and help them overcome fears, embarrassment and better manage their long-term conditions.
For example, with security and anonymity in the arms’ length, yet trusted relationship, patients are more likely to mention that they have noticed blood in their stool or a small lump in their breast. Using the correct, non-directive, terminology, the health coach can then suggest that “your GP would want to know about that because there are a number of reasons for that to be happening and it’s important to confirm the cause so that you can be given any necessary treatment ,” which could provide the necessary spur a patient needs to help early diagnosis and improved chances of recovery.
Health coaching has been shown to motivate patients towards a readiness to change unhelpful thinking patterns. It can facilitate patients’ confidence and skills in self-management, and help them prepare for consultations, particularly in this instance by providing them with the confidence to know they would not be wasting the doctor’s time, proactively consider treatment options and encourage behavioural change. Moreover, with patients conscious that consultation time with their GP is limited, health coaching provides a valuable opportunity for individuals to discuss the longer-term management and implications of their condition with a trained health practitioner – providing that ongoing support patients need as they seek to adapt their lifestyles.
As Britons we have good access to skilled medical staff and cutting-edge treatments; it is therefore critical that the support tools and services are also in place to support individuals in all aspects of their care.
CEO, Totally Health
Competing interests: None declared
Totally Health , Kentish Town, London
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Concern is rightly held over the fact that surgeons who take on more complicated patients will appear to be performing less well under the proposed system for reporting surgeon outcome results; especially as no reassurance that this will be properly taken into account has yet been given. We feel that this problem is particularly at odds with a number of other current topical issues that are currently being debated on a nationwide level by both NHS management and government.
The first amongst these is the Medical Innovation Bill, a private member's bill that currently has had its first reading in the House of Lords. Designed to alleviate the fear of medical negligence claims that have been perceived to prevent doctors from innovating whilst preventing reckless deviation from good practice, this could be of great professional benefit to surgeons; particularly those prepared to undertake radical and novel surgical approaches for aggressive cancers for which the stakes are high. Yet how can such a concept even be discussed when no remedy has yet been offered for the potentially "worse" outcomes that will be published attributable to these pioneering surgeons. Such measures seem positively antagonistic to each other. However it is the doctor-patient relationship that most importantly will suffer, with information savvy patients discovering their surgeons relatively worse-off outcomes, not understanding such information in context. Consequently, the innovative surgeon is punished professionally for bothering to innovate simply by virtue of the proposed system.
A similar topical issue currently is that concerning elderly cancer patients and ageism, a concept that is rightly being addressed. However, should we decide that more older patients are to be operated on for their cancers, this will surely result in worse outcomes across the board; publically available results to which the tabloid press will certainly stoke outrage. The doctor-patient relationship suffers once again.
Whilst transparency is vital for ensuring best practise, in light of these proposed revolutions in the healthcare environment, surely an answer as to how to account for those "difficult cases" is now fundamental if we are to maintain our patient's trust in us, whilst developing a progressive and modern healthcare system?
1)Medical Innovation [HL] Bill. (2012-2013)
Competing interests: None declared
Brighton and Sussex Medical School, University of Sussex, Brighton, BN1 9PX
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