Taiba Shah
Aspects of my future clinical practice that I anticipate will be important to me are to allow patients the right to dictate their healthcare decisions and to ensure that they are informed about their illness. I will utilize truthfulness and autonomy as guide for these aspects.
Underserved communities like Corona and Harlem are where I saw the critical need to strengthen the relationship between physicians and patients early on. I witnessed my parents, who would leave the clinic, knowing only to take their medication as prescribed. They had no foundational knowledge or insight into their chronic conditions. Throughout the years of accompanying my parents on their appointments, I started seeing PAs more often. They were bridging the detrimental gap between physicians and patients. PAs were spending more time with my parents, educating them on their illnesses and answering questions. My parents were impressed, felt more comfortable and preferred to be treated by the PA rather than physician. PAs were not only filling the shortage of physicians in primary care but also exhibiting a unique sensitivity to patient needs. It was evident to me at an early age this leads to overall wellness and health of patients. Observing the influence of PAs on the health of my parents and how it changed their lifestyle sparked my interest and motivated me to pursue a career as a physician assistant.
Important aspects in my future clinical practice will be promoting shared decision making, and patient education. Shared decision is a collaboration between the patient and provider where the patient shares their thoughts, values, and desires and the provider shares medical information and they come to a decision. Shared-decision making will assist patients to dictate their own healthcare. I want patients to feel involved in their treatment because I believe if it will increase compliance to treatment plans. Patient education has shown to increase patient understanding and enhance motivation and improve outcomes (1). Patients should know about their health.
Autonomy is defined as self-governance and it will play the strongest role in promoting shared decision making. Patient’s rights include making autonomous decisions. I will use two of its four meanings to describe how it is applied to shared decision making; autonomy as authenticity and autonomy as effective deliberation. Autonomy as authenticity is when one makes a decision that is consistent with their character, values and desires (2). In shared decision making the patient/surrogate/proxy states what their point of view, and what is important to them. This from of decision making involves a great deal of effective communication. It’s an approach that provides insights into the patient’s perspectives which will influence how I formulate a treatment plan to coincide with their values (3). The medical information I present will assist them in making a decision. After the patient makes the decision I can assess if it is consistent with their true self or something out of character. Autonomy as effective deliberation is assessing if the person has made a decision through a rational thought process. Shared decision making promotes a conversation where the patient can verbalize their thought process. It also ensures information is provided for effective deliberation. They can deliberate the medical information and treatments I present to them and see if it is consistent with their desires. The patient’s perspective required in shared decision will allow for me to assess if the patient is making a decision is a product of effective deliberation.
Truthfulness is being honest while interacting with the patient. It also ties in to autonomy since the patient needs truthful disclosure when determining a course of action (4). Truthfulness is important for patient education. Patient education includes discussing diagnosis, possible treatment options and ways to prevent their condition from deteriorating (1). This helps the patient understand their illness, and it builds trust between the patient and the provider. Patient education involves telling patients relevant aspects of their illnesses like the nature of their illness, outcomes, alternative options honestly. The information told should also coincide with how much information the patient wants to know, and it should be described at a level they can understand. Being truthful while providing patient education will generate better outcomes, ease patient’s anxiety and help the patient to monitor their illness.
Important aspects of my future clinical practice are shared decision making and patient education, and they have been supported by autonomy and truthfulness respectively.
Work Cited
- “Benefits of Patient Education.” LiberateHealth, liberatehealth.us/benefits-of-patient-education/.
- Yeo, M et al. (2010). Autonomy [selections]. In M Yeo et al. (eds.). Concepts and Cases in Nursing Ethics. [3rd edition] Ontario: Broadview Press, pp. 91-97, 103-109.
- Haidet, P. & Paternitti, DA. (2003) “Building a History rather than “taking one” Archives of Internal Medicine 163, 1134-1140
- Tuckett, AG. (2004). Truthtelling in clinical practice and the arguments for and against: A review of the literature. Nursing Ethics, 11(5), 500-513.
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