The doctor has given a diagnosis, what should be the next step in treatment?
In treating conditions such as diabetes, cancer, arthritis, or heart disease, patients may need to work with more than one health care provider. They work as a team to provide the care the patient needs.
Depending on the type of disease, patients may need appointments with different departments, each specializing in a particular type of disease screening or care. Patients may need to consult with a surgical or radiation therapy specialist, or they may seek nutritional or physical therapy-related advice from other medical staff.
Professionals such as care coordinators and patient navigators will guide patients step-by-step through their treatment and help them understand the progress of their treatment.
If multiple doctors are involved in the treatment process at the same time, the new technology also allows them to share information about the progress of treatment, test results, and prescription information.
Guiding patients through treatment
Physicians may be able to refer patients to relevant specialists to help them manage their condition. Kirsi Hayes, RN, a nurse and health coach at Baylor Health Care in Dallas, says doctors may refer endocrinologists to patients with diabetes and cardiologists to patients with heart disease.
At the large hospitals where Hayes works, nurses, social workers and specially trained therapists also provide additional care and support to patients, making it possible for patients to receive care at home all the time, Hayes said, adding that they can also answer patients’ questions about the health care system.
For cancer patients, the health care team may include social workers, care coordinators, nutritionists and even clinical trialists, said Doris Jones, RN, care coordinator at DeKalb Medical Center in Decatur, Ga.
What does the team contain?
Patients may work with the following people in the treatment of their disease:
- A care coordinator, caregiver, or mentor (usually a nurse) to help track the patient’s treatment.
- A specialist such as a cardiologist, endocrinologist, rheumatologist, or neurologist.
- A nurse, specialty nurse practitioner, or physician assistant who helps answer patient questions, perform tests, or prescribe medications in specific situations.
- Surgeons, who perform surgery.
- Physical or occupational therapists, who help patients relieve pain or promote recovery.
- Social workers, psychologists, or counselors to help patients regulate their emotions.
- Technicians who perform x-ray, ultrasound, or magnetic resonance imaging scans.
- A dietitian or nutritionist to help patients manage their daily diet.
Registered nurse Pam Briggs is a care coach at a heartburn treatment facility outside of Atlanta. She is responsible for communicating with all types of patients and coordinating their care.
I also perform exams, analyze the results, accompany patients to procedures and follow up afterwards, she said. We should make patients feel cared for, and they always have a variety of problems and anxiety about their condition. They prefer to communicate with the nurse because the doctor may be stressing them out.
What is a medical referral?
After the diagnosis is made, the doctor or surgeon may refer the patient to a relevant specialist for follow-up treatment. For example, if a patient is diagnosed with cancer, he or she may need to be matched with a radiation oncologist. jones says that the doctor first has to stage the cancer in order to determine the appropriate treatment plan.
Hayes said that if a patient wants a second opinion on the diagnosis or treatment plan, the doctor can refer him to a specialist consultation service that is covered by insurance. She believes that patients often have a lot of questions and concerns when a diagnosis is made that could have a significant impact on their lives.”
Insurers may ask patients to consult a specialist or seek other opinions before determining the terms of their coverage.
How do health care teams share information?
Today, many doctors use electronic medical records systems (EMR) to record patient diagnoses, test results, prescriptions, procedures, and other treatment options in a computer network. Members of the health care team in the same system can share this information directly.
Jones said that with the EMR, physicians can send medical records to each other very easily. In the hospital’s system, doctors with access can review test results, diagnoses, and other information.
Hayes said that EMRs can help improve the efficiency of treatment and make treatment decisions more accurate.
If some members of the medical team are not in the system, other doctors can copy the information and send it to them.
What role does the patient play?
Jones recommends that patients be involved in their own treatment process. Patients can record the interview during the consultation with their doctor, or have a friend or family member record it for them. Also, Jones recommends that patients write down the questions they want to ask before their doctor’s appointment.
Jones said patients may forget important questions on the fly, so we encourage them to write down questions and answers. Medical jargon is obscure, so we recommend that patients take notes to review during subsequent treatments.
Can I get my own doctor involved?
Hayes said that although the patient is primarily working with the relevant disease specialist, his primary care physician can still be involved. The primary care physician can help adapt the treatment plan to the patient’s specific needs or lifestyle.
She believes that patients need a primary care physician who will guide their treatment. This doctor can stay in regular contact with the primary care physician after the patient is discharged from the hospital or when health conditions change.
Patients need to develop a trusting relationship with their physician, which will help with treatment planning.