Shared Decision Making in practice with patient Frans Scholte and pulmonologist Peter van Tilburg
Shared decision-making is the process by which healthcare provider and patient jointly arrive at the best choice about a treatment or certain care. But how does shared decision-making work in daily practice? What is useful to know as a patient? We will tell you about this in a series of interviews on this subject. This episode is about patient Frans Scholte and pulmonologist Peter van Tilburg.
Frans Scholte has COPD, a lung disease in which the lungs are damaged, making breathing more difficult. He recently went to the doctor with increasing complaints of cough and mucus. He referred him to Tergooi MC where a lung attack was diagnosed. The recovery has now set in and things are slowly getting better. ‘I’ve been a patient of Dr Van Tilburg for nine years, but I hadn’t been for the last two years.’
The person behind the patient
Frans Scholte: ‘Dokter van Tilburg is also sporty. That is of course a nice starting point for a good conversation. Due to the open atmosphere in which the discussions took place, joint decision-making is unnoticed. What I liked is that Dr van Tilburg picks up on both the verbal information and the body language and responds to it.’
Pulmonologist Peter van Tilburg: ‘I am no different at the outpatient clinic and in the clinic than at home. I also always try to see the glass half full instead of the other way around, which I also want to convey to my patients. Enjoy what you can and get the most out of it. I am always very curious about the person behind the patient. I want to know who I am dealing with and what expectations and wishes there are. Mr. Scholte is an avid cyclist and physiotherapist. I include things like that in the treatment proposal. It really is a collaboration of the patient and his loved ones in combination with the doctor and the medical team.’
Treatment like a suit
Frans Scholte: ‘For me it was also about medicines that would help me better. Yes, the doctor understands. It’s also a matter of trust, of course. But then it is nice if you get an explanation why one medicine works better for you than the other. I made a list in my head beforehand. A list of questions and goals.’
Peter van Tilburg: ‘Everyone is different and a treatment must fit exactly into your life. It should fit like a tailored suit. That’s why I give patients space first. Space to tell and put thoughts on the table. With that information, we make a plan together. That can result in a completely different approach per person with exactly the same condition.’
Remote treatment
Peter van Tilburg: ‘You sometimes see that patients themselves become somewhat “sloppy” in keeping track of their own complaints, as a result of which deterioration is noticed less quickly. We now have a great solution for this: home monitoring. This way we can monitor the patient from a distance.’
Frans Scholte: ‘Now I alternate telephone appointments with the pulmonary nurse with appointments at the outpatient clinic in Tergooi MC. I find it very reassuring that people look over my shoulder via home monitoring. The argument that in this way a signal can be picked up faster and more effectively in the event of a deterioration was the decisive factor for me.’
Tips for making decisions together
Peter van Tilburg: ‘I would advise other care providers to avoid difficult language and to explain things clearly. If necessary, draw things out on paper. Ask your patients to briefly repeat your own explanation. A tip for patients: talk openly and honestly with your doctor, make sure you understand what steps are being taken and why. Thinking ahead of time to ask your doctor is highly advisable. So invest time in your appointment in advance.’
Frans Scholte: ‘I would advise patients to take someone with them to an appointment and write down their questions beforehand. I would like to call on healthcare providers to first give the patient the space to tell his or her story. Include the questions and emotions in clear steps in the treatment plan.’