Most of us recognize the challenges healthcare institutions face in balancing budgets in a time of escalating costs. So, how do hospital administrators decide what projects or services should be funded and what are expendable? It seems that in most instances the basic principle of “income producing” is what determines what stays or goes.
What brought this issue to mind was re-reading an editorial that appeared in the Bennington Banner in January 2006, soon after the medical humanist program was cut from the hospital budget. It was written by Bob Morton whose wife Barbara was a breast cancer patient.
Mr. Morton wrote, “As Dr. Pillemer explained very early on, Barb would have to adjust her outlook “to living with cancer rather than dying from cancer.” Although this phrase has been often repeated, and we accept its veracity, it becomes difficult to hold on to its meaning amid the surgeries, hormone therapies, and various side effects these produce. However, the Cancer Center added to its staff a person whose specific purpose was to get the oncology patient to focus on “living with cancer.” Cecelia Bandman was the most incredible source of compassion, sympathy and caring we have ever encountered through our nearly 15-year history of “living with cancer,” Her experience with cancer patients provides her with a unique ability to understand their emotional trauma and communicate in an informed, caring and trusting way. Not only did she provide a bridge between the doctor and the patient but has also between the patient’s present and future. Ceil filled a void we didn’t know existed before we met this wonderful “Medical Humanist.” Now that her grant period has expired and her services are no longer available, that same void seems vastly larger.”
He continued, “Apparently, the leaders of the hospital have little or no concept of how important services of a medical humanist are to critically ill people. Instead of allowing this service to disappear at the end of the grant period, it seems that a truly caring administration would find the means to maintain, if not expand, these services to medical areas beyond the Cancer Center. The truth is, unless you have actually walked the path, and I hope none of you will ever have to do so, you can have no idea of the value a medical humanist such as Cecelia Bandman can bring to the overall care of the patients of Southwestern Vermont Medical Center.”
I was deeply touched by what Bob Morton said about me. I’m not sharing this testimonial to toot my horn but to emphasize what so many patients and families feel but may not articulate. Although there may never be another medical humanist program in cancer care or any medical practice, patients want to be heard and understand what they are facing.
What I learned during those years served as a foundation for developing “SpeakSooner®: A Patient’s Guide to Difficult Conversations”, a tool similar to a medical humanist’s note. The Guide was designed to help patients identify and communicate needs, concerns and preferences, leading to informed decisions about care. As a result, patients can become their own medical humanists.
By in large, healthcare institutions recognize the importance of patient-centered care but may not fund programs aimed at improving communication because of budgetary priorities. I understand how this works from firsthand experience. Although it may be a tough sell for healthcare institutions to underwrite training programs in use of the Guide, it would be a small dollar investment but a big return in support of patient-centered care, especially for those facing serious illness.