IRQ Articles

President's column

05-01-2017 20:54

President’s challenge: Are you a clinician or a patient advocate?

By Suresh Vedantham, MD, FSIR  Spring 2017

As we celebrate how far IR has come as a clinical practice discipline, one remembers Maslow’s hierarchy of needs: safety, food, love and belonging, self-esteem, productivity, aesthetic appreciation, and finally self-actualization. Most of us are proud of having evolved from adept imagers to outstanding proceduralists to astute clinicians and, for some, to disease subspecialists. Indeed, these are incredible transformations.

Yet, we share a nagging sense that, in some respects, IRs are not always viewed as first-class citizens among our peers outside of interventional radiology. Somehow a medical physician is viewed as the more credible expert on a disease and its treatment, and somehow it is easier for a surgeon to influence the health system on procurement decisions or to obtain resources for new clinical development propositions.

The first question to ask ourselves is if we have truly convinced our patients and colleagues that we are, first and foremost, patient advocates.

These are the kinds of problems you have when you’re relying on your voice alone to tell your story. Given the incredible impact we have on so many patients’ lives, it is fair to wonder why others aren’t also telling our story. The first question to ask ourselves is if we have truly convinced our patients and colleagues that we are, first and foremost, patient advocates. As part of their training, nurses are taught to become the patient’s advocate—that is, to build a supportive relationship with the patient, proactively anticipate his or her needs and push the system to satisfy them.

Some physicians do it well too; for example, although oncologists mostly prolong lives (at best; sometimes not even) rather than saving them, each has a large population of cancer patients who see him or her as their primary advocate. That, in fact, is likely the primary job satisfaction an oncologist gains on a day-to-day basis, and when needed he/she can channel the patient’s voice to incredible impact in influencing the health system.

I hereby challenge every IR to define himself or herself as a patient advocate. Ask the hard questions. I’m a great clinician, but am I really a patient advocate? Do my actions show that I see my patients as people, and that I am interested in their long-term well-being? Do I follow them for the minimum time needed to exclude short-term complications, or do I build lasting relationships? Do I merely deliver care, or do I anticipate patient needs and fight for them to be met? Do I actively participate in health system quality initiatives? Do I only become engaged when I see an opportunity to promote procedure use? Do my non-IR colleagues see me as an advocate for their patients? A test: when I save a patient’s life from bleeding or infection in the middle of the night, did the patient know that it was me when he or she leaves the hospital? If the answer is “no”, ask yourself why not.

We have work to do, but reinventing ourselves as patient advocates will ultimately provide the next “sonic boom” that lifts IR to a new level in its regard by patients, providers and health systems, enabling us to realize our full potential as a clinical discipline. In an increasingly impersonal health system, patients are hungry to find advocates. We provide tangibly positive outcomes with less discomfort and recovery time. We already deliver “personalized” medicine—individualized to the specific anatomy, physiology and clinical context of each patient. We’re unquestionably poised to win on our merits—we just need to be willing to evolve once more.

This is important to us as a society. In the near future, you will see SIR increasingly channeling the patient’s voice to amplify yours in telling your story. Even in the most contentious places, a patient’s involvement silences the room and pushes everyone to play better in the sandbox. A few weeks ago, I participated in a guidelines development panel that included a patient advocate. I was amazed. The leading authorities in the world debated a nuanced and impactful clinical practice recommendation with great vigor but when our patient advocate spoke, her voice carried the day.

I have personally witnessed the ability of patients’ self-told stories to move mountains in other places—including the mass media, Congress and the business community—cutting across all limitations of size and finances. Creatively engaging our patient base is a crucial dimension that we must add. And the best part is that the effort made to evolve into a society of patient advocates will attract talent, strengthen our relationships with our patients and thereby enhance our ability to deliver better outcomes.

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