Tag Archive for: patient-centered care

Peer Insights: Practicing Cultural Humility to Empower Your Patients

Peer Insights: Practicing Cultural Humility to Empower Your Patients from Patient Empowerment Network on Vimeo.

How can healthcare providers practice cultural humility to empower their patients? PEN’s Vice President of Programs Aïcha Diallo discusses barriers healthcare providers may encounter and advice for overcoming or minimizing these barriers to cultural humility.

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Cultural Competence vs. Cultural Humility

Cultural Competence vs. Cultural Humility Infographic

Aicha Diallo

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Cultural Humility Fostering Respect & Understanding Your Patient's Unique Identity

Cultural Humility: Fostering Respect & Understanding Your Patient’s Unique Identity Infographic


Dr. Nicole Rochester:

Cultural humility has practical implications for improving healthcare outcomes such as improved communication, empowerment, and trust between providers and their patients, and also enhance patient-centered care. But we know that there are barriers that may exist to putting these things into action. Aicha, what are some common challenges that healthcare providers face when trying to practice cultural humility?

Aïcha Diallo:

Some of the things that I’ve been seeing is really not being able to carve out enough time to listen to their patients’ unique traits, unique characteristics, needs, wants, concerns, or even goals. We always encourage our patients and care partners to put all of this on the table and to share this with their healthcare teams. But something that we always hear is that there wasn’t enough time allocated to even go there.

So that is a challenge for someone who wants to practice cultural humility but doesn’t have enough time to be able to do that. I would also add to that, that it’s giving, and I sort of mentioned this earlier, sort of giving enough room for their patients to feel comfortable to engage in shared decision making, for them to feel that they are co-decision makers and it’s the time for them to express what’s going on. And to even add more. 

Another challenge is working in an environment that does not always promote cultural humility. So the healthcare professional might feel alone and feel that they’re practicing this on their own, and there are no other colleagues or no one else with them throughout this. One of the other things I would like to also add as a challenge is not being able to work as a group to identify some of the patient’s barriers that they’re facing and even providing helpful resources that could be meaningful to them.

Dr. Nicole Rochester:

Thank you. You’ve talked about a lot of these barriers that are really outside of the control of the provider. And so that brings me to my next question, which is really about the systems in which we provide care. What is the role of healthcare institutions supporting ongoing learning and environments that actually promote cultural humility so that providers can truly empower their patients?

Aïcha Diallo:

It’s really ensuring that patients and their families can access effective and equitable care regardless of who they are, where they’re from, what they look like, where they live. I think here at Patient Empowerment Network, we have several cultural humility resources for healthcare professionals, which include infographics that are embedded in the EPEP program and other resources that incredibly useful and important to them to access at their fingertips and be able to feel empowered themselves so they can continue to empower their patients.

We have added recently over a 100 languages to our website to make sure that our resources are available to anyone. And one of the last things that I would add as well is we continue to encourage healthcare professionals to share our PEN’s resources because by doing that, not only that the healthcare professional empowers themselves comes ready with information and comes humble with a step back and say, please share more.

But they’re also able to provide those resources and programs to their patients so they can access them so they could also feel empowered. So I would add, please continue to share our PEN’s resources. Make sure you include a lot of the tools and the tips that are useful for your patients regardless of what language they speak or where they live or again, where they’re from. So providing our digital literacy skill programs are also really important, our Digital Sherpa and Digitally Empowered, with your patients and families as it will provide them with some additional insight and a way for them to feel that they do have presence and they sit at the table to engage better with their healthcare teams.

Dr. Nicole Rochester:

Thank you so much. This has been such an enlightening discussion and lots and lots of resources that PEN provides. And thank you for all that you all are doing in this space. Aicha Diallo, vice President of Programs at Patient Empowerment Network, thank you so much for your wisdom and your insight.

Aïcha Diallo:

My absolute pleasure. Thank you so much for having me.

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How Can Prostate Cancer Providers Help Empower Patients?

How Can Prostate Cancer Providers Help Empower Patients? from Patient Empowerment Network on Vimeo.

 How can prostate cancer providers help empower patients? Host Dr. Nicole Rochester and Drs. Yaw Nyame, and Petros Grivas share their perspectives on how health providers can work with patients to empower them to make more informed decisions in their treatment journeys toward optimal prostate cancer care.

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Dr. Nicole Rochester: 

I’m going to ask Dr. Nyame to elaborate on which is these fancy tests and these new technologies and things, and what we know is that a lot of times the patient themselves, if they are not aware of these particular tests, then because of all the disparities that we’ve talked about, they may not even be offered to them. And so a question for you, Dr. Nyame, how can we empower patients so that they don’t feel limited in their care, and how do we make them aware of these treatment options and diagnostic options?  

Dr. Nyame: 

You know that’s very challenging because Dr. Grivas and I see this in our clinical practice, we have patients who are very savvy, that’ll come in and say that “I’ve heard that there’s a PSMA in San Francisco. Do you have it in Seattle? If you don’t have it in Seattle, I’m going to go to San Francisco.” And for every patient I had like that, who might be, “Hey, have you read this latest article, I can have someone who has no idea of what’s going on with their diagnosis, and so how we create opportunities to bring those patients and know very little up to somewhere close, maybe not quite to the demanding the PSMA or a fancy scan level, but sophisticated enough to feel empowered in their health decision-making as something where I think we need to do research because we know that certain tools, navigation, advocacy groups can help in that arena, but I think that we need to understand what the tools are that patients want. What’s interesting is when you query patients, which we’ve done in a study and you say, “What are the most pressing issues for you in your prostate cancer diagnosis,” whether it’s in the localized setting or in the advanced or metastatic setting, the one thing that has resonated over and over again, irrespective of race is, “I need help making decisions, I need tools that will make it, me more efficient in how I make my decisions.” And so, I think without punting the answer too much, we need to do better, and I think part of that starts with listening. I do think that providers can be trained to provide that information in a more efficient manner. We do not…we as clinicians, are built into a system where the number of patients we see really correlates with how we get paid, and there’s not a doctor that doesn’t go to work excited to educate and build relationships with patients, that’s not the case, but there is a time crunch and I feel like in situations where there is a bigger gap and knowledge and understanding, we often don’t have enough time and built into our day to have the discussion, so for me, for a lot of my patients who I feel like have a lower understanding of what’s going on with regards to their prostate cancer diagnosis, it’s really important for me to build into our visit the understanding that whatever we don’t cover can be addressed at a later time and that we don’t have to make a decision with that at particular visit. So, when I think about this, it’s sort of like your favorite barbershop or your favorite grocery store, your favorite sandwich place, the relationships matter. 

And I think when we talk about empowering patients to be advocates for themselves in their clinical visits, I think there needs to be an understanding from patients that if it doesn’t feel right, that they have options and to take their time in the decision. Prostate cancer, unlike other diseases, that Dr. Grivas and I treat doesn’t have to have the dial turn to 10 or 11 right away, and we need to make a decision because time is extremely sensitive, even in our most aggressive localized settings, which is what I treat, we have the opportunity to take weeks, if not months, to come to a decision. 

Dr. Nicole Rochester: 

Thank you, thank you so much, I appreciate that. And certainly, as a physician who’s also a health advocate, I strongly agree with what you said about if the relationship is not working, that there are options, and I know that that may not always be the case depending on where patients live, but I regularly encourage my clients to sometimes you have to look somewhere else, sometimes you have to get a second opinion or maybe even fire your doctor if the relationship is not mutually beneficial, so I appreciate you sharing that. Dr. Grivas, do you have anything to add in terms of how patients can take a proactive approach to their healthcare and how they can build this confidence we’ve been talking about and express their concerns to their medical team? 

Dr. Grivas: 

I think Dr. Nyame covered it so well. I think it’s critically important for all of us to recognize that the finding out the why is probably the key to answer those questions, why there is this distrust, why someone is not paying attention so her own health because they have to try to make ends meet and keep family fed during the daytime, and they don’t have time to think about their own health as Dr. Nyame mentioned before, at the same time, empowering the patient that they are the center of this relationship. 

Why doesn’t Dr. Nyame go to the clinic in the morning is because of patients, so our training is patient-centered and our practice is patient-centered and our research is patient-centered, so the patient should feel that right from the door, that this is a service to them. And we’re doing what we’re doing to help their life being longer, longer survival, as we call it, or better, better quality of life, and listening to the patient’s needs is important because of the time crunch that Dr. Nyame mentioned before, I think many of us, probably all of us are within situations where we don’t have enough time to listen advocate-ly, what the person have to say, that’s why I think it’s important to have opportunities for separate visits and utilize better other mechanisms, exact mechanisms, patient navigation I think it’s a critical part of our care, social workers, case managers, financial counselors, nutritionist, genetic counselors, looking at genetics in for the disposition to cancer which is much more common than we think occurrences sometimes we be higher in some certain populations. Having this service available to patients, can help a lot because they will give them knowledge, and knowledge is power by itself, so give them the center, we’re here for them. Why they’re here, it’s because we want to help them and giving them also resources, they need to get now let’s information, when they feel they have more knowledge and they feel that they have control, they can communicate back and give feedback of how we can do better and also, what are the priorities of their needs, so we can address those, what matters to the patient, and this can apply to base and care, and also is what questions we’re asking? Research should be defined by patient priority, so all of those factors should be a dialogue with a patient, I think advocacy groups can be a great liaison to help us disseminate this concept and help again, empowering the patients. I struggle believe that explaining the why and giving knowledge, the data points in a simple and lay manner, can patients think being more in control. 

 Dr. Nicole Rochester: 

I love the patient-centered focus, that is something that admittedly, we’ve gotten away from that to some degree in medicine because of the time crunches that both of you have mentioned, and I love that you said knowledge is power.  

How Can Breast Cancer Patients Connect to Patient-Centered Care?

How Can Breast Cancer Patients Connect to Patient-Centered Care? from Patient Empowerment Network on Vimeo.

What actions can breast cancer patients take to connect to patient-centered care? Dr. Regina Hampton shares insights about breast cancer resources that aid in supporting whole care of the patient.

See More From the Best Care No Matter Where You Live Program

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Dr. Nicole Rochester: 

Something that I see in my field is that most patients and family members are operating from obviously a non-medical viewpoint, and sometimes they just don’t even know what questions to ask, how can we empower patients so that they don’t feel limited in their care, and how do we make them aware of the treatment options that are available? 

Dr. Regina Hampton: 

So I think the good thing about many breast centers is that they do have what are called navigators, who really sit and hand-hold the patient through the process, and they sit and do one-on-one counseling, they try to find resources to help the patient get through treatment, they hold support groups, they really are a wealth of information and a nice go-between between the patient and the physician or the provider. So trying to find a comprehensive breast center where they have a whole program that’s dedicated to patient-centered care, I think is important. It’s also important that patients be empowered to go online, you can find what questions do I ask? Print it out and bring it to your appointment and ask those questions, and it may take a couple of visits to get those questions answered, but I think it’s important to get the questions answered. If you’re with a provider who is feeling like they don’t have time to answer or they’re blowing you off when you’re answering those questions, guess what? You can fire your doctor and go find another doctor and I don’t think we do that enough. 

I get on my patients and say, “You know what, you all scrutinize when you go buy shoes, when you go buy that cute dress, when you go buy that new car, but we should scrutinize our providers because they’re taking care of our most precious commodity, and that is our body.” 

Dr. Nicole Rochester: 

That is absolutely true. I have fired a couple of doctors in my day, and I recommended that some of my family members fired their doctors as well, so I really appreciate that coming from you, Dr. Hampton. And you touched on a little bit on what I’m going to ask next, and not really staying on this advocacy piece, we’ve talked about the importance of patients feeling empowered, and you shared a really good tip which I love, which is writing your questions down, it’s something that I frequently recommend to my clients and my friends and family members.