Neurological disorders such as Alzheimer’s disease and Parkinson’s disease are some of the most emotionally complex and difficult to manage cases that physicians face, deeply affecting the patient’s sense of identity and their relationships to loved ones. Yet medical staff are often ill prepared to help patients through the experience.
One part of the problem is that physicians lack the time to address these issues and another is that they often lack the training to do so.
Graham Atkin, assistant professor of radiology, is working to address the latter issue.
As a doctoral student in neuroscience at the University of Michigan, he took part in events where patients and families dealing with dementia heard from scientists about the latest research developments. He discovered that the exchange of information was bidirectional.
“Patients don't always understand what neurodegenerative diseases are at the biological level, but they have incredible insight into these conditions at the practical level, because they're the ones that are living with them,” says Atkin. “We learned as much from them as they did from us.”
He often heard that physicians fell short when it came to explaining a diagnosis, showing empathy, and responding to patients’ psychological needs. They were also unable to direct patients to resources that could help in those areas. Atkin realized that this was not entirely surprising.
“Students are not typically taught these topics in lecture,” he says.
Three years ago, Atkin founded the Patient Conversations program, working with dementia support organizations in Battle Creek to fill in that educational gap for MSUCOM students. This year the program also included a Detroit-area organization, PACE Southeast Michigan.
Participating first-year students spend a day at a dementia support facility and meet one on one with patients and their caregivers to discuss issues surrounding dementia.
The program emphasizes the need for physicians to consider the big picture and to better use all available resources.
“[Patients and their caregivers] need doctors to consider a person's life, what they actually have to go through, to find the best plan of care available. That takes working not just with medical or mental health professionals. It's about community,” says Anne Clark, eldercare specialist and caregiver coordinator at Senior Health Partners in Battle Creek, a Patient Conversations community partner.
Students say that after attending Patient Conversations they feel much more confident discussing neurodegenerative diseases with patients and their families and sharing community resources available to them.
“It was an amazing opportunity that every medical student needs to experience. I think what I learned today and the impact the conversations had on me will shape me into a better physician and communicator,” said first-year student Sonal Kaushik.
Through the program, patients have also found a new voice.
“No one else in our medical appointments has ever asked us for any feedback or about our satisfaction,” said Cindy, who cares for her husband Mahmoud.
The program started with six participants. The following year it was capped at 12 and filled in a few days. This year Atkin signed up more than 50 participants within two hours.
He is eager to build on the program’s success and envisions integrating activities like it into the medical school curriculum, from pre-clerkship to residence.
“These diseases are difficult for physicians to handle, and even more difficult for patients and their families to talk about. Somebody in that equation needs to be skilled and brave and having honest conversation with people about what's going on and to really listen,” he says. “I would like our physicians to be those brave, skilled people.”