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Aug 9, 2010 · Leave a Reply

The value of an unhurried conversation

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by Victor Montori, MD (Wiser Choices Program)

As we reflect on the present and future of healthcare, it is key to consider the value of an unhurried conversation.

At the Mayo Center for Innovation 2009 Symposium, Maggie Breslin made a compelling case to focus on conversations as a key strategy to improve healthcare.  Watch her inspiring and inspired proposition here.

Becca Camp, a visiting student at our KER UNIT, recently wrote a blog post of an experience at Mayo Clinic she was privileged to witness.  In it she noted the relationship between an unhurried conversation and the opportunity to contextualize care to a patient’s specific situation, a requirement of both evidence-based practice and patient-centered care.  A recent rigorous and careful study documented how failure to pay attention to context can lead to poor quality care.

Don Berwick in his address to the Yale Medical School 2010 Graduating Address, he noted the critical importance of patient-centered care and the role that clinicians can play in treating patients with respect and humanity, urging them to

...recover, embrace, and treasure the memory of your shared, frail humanity – of the dignity in each and every soul.

Meantime, we seek to measure value in healthcare and we find it difficult to articulate how to capture the value of the unhurried conversation.  How do we know that our systems promote these conversations?  Should we protect these, and if so how, when economic considerations (payment, demand, access) threaten them?

The unhurried conversation, a key component of the Mayo Model of Care, should be the focus of intense investigation.  How much time is necessary to achieve this experience?  How should care professionals be trained to participate?  How do new requirements for healthcare provision affect these?

I believe it will be up to patients -- thru a strong patient movement -- to make sure the unhurried conversation remains a possibility as healthcare changes.  And it will be up to us to provide the resources and knowhow to realize that possibility.

Tags: Patient engagement, SDM in practice

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