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| Multiple Sclerosis Centers |
As a result, the doctor-patient relationship in MS differs significantly from the traditional diagnosis-treatment-cure model that often applies to acute illnesses. In a long-term illness like MS, a more comprehensive model, involving diagnosis + education + collaboration problem solving + support, begins with a timely diagnosis and continues for the remainder of the person's life. This model of care promotes the person's efforts to live comfortably and cope effectively with the ongoing demands of the disease.
The role of the physician in a chronic illness like MS is described, and the model of comprehensive care that has gradually evolved in response to the long-range needs of individuals and families living with MS is discussed. Next follows a look at the impact of "managed care" on the comprehensive care of people with MS, and recommendations for ways that individuals and families can work with their physician and healthcare team to maximize their own health and well-being.
The Role of the Physician in MS Care
THE EARLY HISTORY of MS care was often characterized by what the late Dr. Labe Scheinberg called the "diagnose and adios" school of medicine. Many physicians, frustrated by their inability to provide patients with a cure, gave them a diagnosis and sent them on their way - to live with MS as best they could. Other doctors were reluctant to give the illness a name, and simply told patients that it was a virus and nothing to worry about or, worse yet, that the symptoms were all emotional and required psychiatric treatment.
When physicians shy away from an illness they cannot cure, or withhold vital information from patients and their families, their own discomfort is clearly communicated. The patient and family feel abandoned and burdened with the weight of uncomfortable feelings and unanswered questions.
A meaningful doctor-patient collaboration begins with an accurate diagnosis. Once the diagnosis has been made and explained in a straightforward and understandable way, the person (and his or her family) can begin learning how to adapt to, and cope with, life with the disease. This initial phase of the doctor-patient relationship can, and should, set the stage for the entire therapeutic relationship. Hearing the diagnosis from a physician who conveys the information in a thorough and supportive manner gives the person a greater sense of control and mastery. It conveys the reassuring message that the doctor is there "for the long haul," to help the patient and family members learn to deal most effectively with the disease and manage any symptoms or problems that may arise.
Once the MS diagnosis has been made, the physician's focus shifts to treatment, not only of current symptoms, but also of the disease process itself. The doctor's goal is to help each person live optimally with MS, both now and in the future. Because each patient is unique, the doctor can only achieve this goal if he or she takes the time to understand the person's values, lifestyle and priorities, as well as the current symptoms. Armed with this information, the doctor can begin to educate the person about available treatment options for the short term (e.g., management of specific symptoms) and the long term (e.g., treatment to reduce the number of attacks and slow disease progression). Using a supportive, educational approach, the physician engages the patient and family in the treatment process, working to create an atmosphere that encourages open communication and active collaboration. To find out more, you can check out Multiple Sclerosis Centers.