Team Medicine: Creating a True Partnership With Your Healthcare Team

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Topics include: Living Well and Treatment

Andrew Schorr speaks with Dr. Sapna Patel, Dr. Mark Gimbel and Martha Bishop about team medicine, the importance of communication and treating the whole person. Dr. Patel carries out a partnership between herself and her patients and knows communication of details is key during treatment, especially when tracking patients’ medicine—prescription or herbal, which can have effects during treatment. Dr. Gimbel also talks about resourcing support, such as psychological therapy. 

This in-person town meeting was sponsored by the Patient Empowerment Network through educational grants from Genentech and Novartis. It was produced in partnership with Banner MD Anderson Cancer Center, and the Melanoma Research Alliance.

 

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Transcript

Please remember the opinions expressed on Patient Power are not necessarily the views of our sponsors, contributors, partners or Patient Power. Our discussions are not a substitute for seeking medical advice or care from your own doctor. That’s how you’ll get care that’s most appropriate for you. 

Andrew Schorr:

So, Martha, to hear Dr. Wong tell it, then you’re really in a partnership with your doctor.  And you have to have open communication. You can do your part, but you’ve got to work together with somebody you trust. How do you do that with your doctor?

Martha Bishop:

For me being in the clinical trial, I’m watched very closely. And like we talked about, having everything ticked off, and how much are you drinking? When did you start itching?  And I am very lucky to have a caregiver who is very good with dates, because I am horrible at it. 

How many months ago did that start?  I don’t remember. So it’s definitely a little bit tricky, but it’s nice to have that extra care, another bonus of being in a clinical trial. 

Andrew Schorr:                  

So, Dr. Patel, do you encourage teamwork, if you will? Do you see them as your partner? 

Dr. Patel:               

The patients?

Andrew Schorr:                  

Yeah.

Dr. Patel:               

Yeah. I mean, absolutely the patients are our partners. And just like Dr. Wong and Martha said, you have to—not everybody tells their doctor about the supplements they’re taking. And some of it is I think this concept that they’re going to not like it. They’re immediately going to say to stop it. Don’t take it. And there are physicians that will say that. But I think there have been plenty of complementary medicine studies that show 90 percent of our patients are taking something that is not on the medication list that the hospital or the clinic is tracking. And all of that matters.  I have the same story as Dr. Wong.

A patient who I was going to start some chemo on, she had no mutation, and this was before surgery she was going to have for a mucosal melanoma.

But before I started, her liver enzymes were three times the upper limit of normal. She doesn’t drink alcohol.  She doesn’t take Tylenol (acetaminophen).  But she had 20 herbal medications on her list.  And she said, “But I’ve been doing this for a long time. Nobody said it’s a problem.” And so I contacted her home doctor and got some home labs. He wasn’t checking liver function.  He was checking other things, salts and sodiums and calciums and CBCs but wasn’t checking liver.  And I said, “Just do me a favor. Stop it, come back in two days, and let’s see because I cannot give you this chemo with your liver like this.”

And in two days, her numbers were normal. And she said I never would have realized.  It’s not that all 20 of them are culprits, but you just have to be very careful. The only way to do that is to be in partnership with your provider, share the medications and then have the dialogue about are they causing harm? Do we need to hold some? And so on and so forth. 

Andrew Schorr:                  

So, Dr. Gimbel, so you’re both at the same institution. And we talked about team medicine earlier. 

So you do your surgery on somebody, but they are maybe going on with the fear that it’s going to come back.  So is that when you recommend, hey, we have a psychologist? There are other resources to draw on for you to help you with this?

Dr. Gimbel:          

A lot of it is patient-driven in terms of what they want and what they need.  And you can gauge that during interactions. Some say just get me the treatment. I want to go, I want to go, I want to go. And you try to steer them to that direction. Other ones, you can see how it’s becoming all-consuming and really affecting their quality of life. And when it gets to that point, then we have to steer the direction for the patient to help them try to be able to manage the situation better. So yes, it’s a team approach. Which team members are at the forefront varies based on patient need. 

Please remember the opinions expressed on Patient Power are not necessarily the views of our sponsors, contributors, partners or Patient Power. Our discussions are not a substitute for seeking medical advice or care from your own doctor. That’s how you’ll get care that’s most appropriate for you. 

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Page last updated on July 17, 2017