Talking about Serious Illness with Your Primary Care Provider
Determining what matters most to a patient living with a serious illness is important to their quality of life. A primary care provider can serve as a trusted resource who’ll help lead an open and meaningful conversation when a patient is faced with a serious illness.
“Ideally, with a goal toward reaching better outcomes, clinicians should discuss a patient’s options and desires while they are able to thoroughly participate in the decision making process,” said Ed Nalband, MD, South Shore Medical Center.
A provider might guide his or her patient through a conversation on managing serious illness using questions that can be helpful in determining the patient’s goals, worries, wishes, and preferences.
- What is your understanding now of where you are in your illness?
- How much information about what is likely to be ahead with your illness would you like from me?
- What are your most important goals if your health situation worsens?
- What are your biggest fears and worries about the future with your illness?
- What gives you strength as you think about the future with your illness?
- If you become sicker, how much are you willing to go through for the possibility of gaining more time?
The Serious Illness Care Implementation Collaborative – which offers training to primary care physicians in partnership with Ariadne Labs, the Center to Advance Palliative Care, and VitalTalk – is a pioneering effort centered on the Serious Illness Conversation Guide and other components of the Serious Illness Conversation Program (SICP).
Fifteen health systems from across the United States are participating in the collaborative to initiate more, better, and earlier conversations with seriously ill patients, reaching diverse populations from coast to coast.
South Shore Health recently joined the Serious Illness Care Implementation Collaborative and is in the beginning stages of introducing the program to its physicians at South Shore Medical Center in Norwell.
The initiative is grant funded to South Shore Health from Blue Cross and their partnership with Ariadne Labs, and will be phased in over the next 24 months, with the intention of creating a standard of care.
Serious Illness conversation training will occur in phases at South Shore Health and be will be offered to clinicians and staff members who serve in a variety of roles -- such as Advanced Practice Clinicians, social workers, case managers, and nurses.
The Collaborative brings together leaders and teams from around the country who are working toward a shared mission: to ensure that all people with serious illness have conversations about what matters most to them in order to drive the care they receive. The impetus of the collaborative is to ensure health systems have the tools and expertise to initiate these conversations to more patients.
“Understanding what patients and families care deeply about are the reasons many of us went into medicine and health care in the first place,” said Dr. Joanna Paladino, director of implementation for the Serious Illness Care Program at Ariadne Labs.
“Our members are leading the way by investing in culture change in order to make high-quality serious illness communication the standard of care.”