Beyond the Hospital Walls: A doctor’s lessons inโ Person-Centered Care
After relocating to the United States, my career took a pivotal turn as I began working with JASA, a leading provider of services โฃfor older adults in New york City.This experience quickly illuminated a gap in my medical training – โthe realities faced by patients โ after dischargeโค from the hospital. While medical school focused on treating illness, I discovered the profound impact of social determinants, daily struggles, and isolation on recoveryโค and overall well-being.
Oneโ patient, whom I’ll refer to as โคMr. Happy, profoundly shapedโข my understanding. He โhad recently been released following a lengthy hospitalization for congestive heart failure and ascites related to colon cancer. Initial contact proved tough;โฃ a social worker cautioned me he wasโ frequently enough unreachable and resistant to engagement.โฃ However, โฃonce we connected, he became an invaluable teacher alongsideโ being my patient.
my first significant realization came during a home visit. Mr. Happy’s apartment was almost bare. His belongings had beenโข discarded during โhis hospital stay, leaving him without basic necessities – a chair, linens, even clothes. He understandably felt anger and shame. Fortunately, through JASA’s resources, we were โขable to provide him withโค clothing, shoes, linens, and a pleasant recliner.
Reviewing his medications revealed anotherโฃ critical barrier. He had stopped taking his heartโค failure medication due to its cost without insurance coverage. I proactively โคcontactedโ the pharmaceutical manufacturer, โsecured a coupon, and coordinated with his pharmacy. Within hours, he had his prescription filled. We then meticulously reviewed each medication together, utilizing the “teach-back” method to ensure understanding, and created a simplified list for him to follow. He consistently took hisโข medication from that point forward, highlighting how labels of “non-compliance” frequently enough mask โขsignificant, practical obstacles to care.
The most transformativeโฃ shift in my approach cameโ withโ JASA’s adoptionโฃ of the Age-Kindโข Health System framework, centered โฃaround a single, powerful question: “What mattersโฃ most to โyou?”
This question fundamentally โคaltered my perspective. For Mr. Happy, regaining his health meant spending time with his family – his son and siblings โ- and returning to his beloved chess games โin the park.We workedโ collaboratively to achieve โthese goals, arranging transportation, medication delivery, and home aide support,โฃ and assisting him in securing ongoing insurance coverage.
I learned that genuine healing begins with truly โlistening โขto aโฃ patient’s priorities. Mr. Happy evolved from a patient into a mentor. During my final visit,โ we shared a gameโข of chess, honoring a central element of what mattered most to him. He reinforcedโค the importance ofโฃ compassionate, person-centered care, โฃbuilt โขon empathy and a trueโค partnership between doctor and patient, as the very foundation of medicine.
(Dr. Jose R. Martinez-Escudero is theโค associate director of transitionalโข care for JASA at Maimonides Hospital, where he โขsupports underserved older adults navigatingโข the healthcareโ systemโ in New York City. He received his medical training at the National Polytechnic Institute in Mexico City and holds a master of Science degreeโข focused on research in Parkinson’s disease andโ the basal nuclei.)
