The American Holistic Nurses Association describes the holistic care model as a "practice that has healing the whole person as its goal." This model treats each patient as an individual participating in their own care and takes their preferences and beliefs into account instead of simply focusing on their physical ailments. As our healthcare system becomes increasingly focused on streamlining and efficiency, people may struggle to receive care that is seamless between specialists or facilities. Many patients become lost in the system, bouncing between providers who may not understand their full medical story and may simply give up out of frustration.
As NEJM Catalyst noted, the medical research community has known about the positive relationship between good physician-patient communication and health outcomes for 10 years or more, but market forces have only recently brought this issue to the forefront. A value-based payment system necessitates that every interaction between the doctor and patient be as fruitful as possible. Both physician and patient satisfaction are improved through effective communication, but it is the former's overall well-being that benefits the most from a relationship that makes them feel heard, respected and safe.
A 15-Year Quest for a Diagnosis
In The Atlantic, a patient described her 15-year journey in search of an elusive diagnosis. She knew something was wrong, but seeing as her physicians could not identify the cause of her illness, she experienced complications and endless tests. During this time, her mother was also being treated for and dying from cancer. She described the healthcare environment as the "Mad Hatter's tea party," because even though the hospital was supposed to be a place of healing, she found it to be loud and impersonal. The doctors and nurses were mostly nice but could, at times, be "brusque and even hostile." Although she was being cared for (one complication at a time), she felt her physicians were not listening to her and her symptoms were never viewed as a whole. Ultimately, a physician she described as "sympathetic" tested her for an autoimmune disorder, which led to a diagnosis of Lyme disease at the end of 15 long years.
Improving Patient Care Through the Holistic Care Model
Most clinicians have been faced with increasing their volume of patients in order to bill and collect sufficiently to sustain a viable medical practice. As the U.S. healthcare system turns to value-based payments, however, inefficiencies such as return visits, repeated hospitalizations and duplicated tests are discouraged by the reimbursement process. Gynecology practices are focusing on efficient imaging and medical-record systems, and they are offering more services in-house to create a better overall experience. Still, patient satisfaction depends on more than systems and tests. If, as NEJM Catalyst stated, communication has a direct and positive effect on outcomes, then this aspect of care deserves increasing attention.
Practical Nursing observed that when healthcare workers rush through an appointment or have a poor bedside manner, patients may be left feeling burdensome to their caretakers. The patient may be disinclined to return to a particular physician at all if an encounter was sufficiently unpleasant, and they may have left without enough information to take care of their medical needs.
Practical Nursing describes a holistic care model that promotes a "healthy psychological, emotional and spiritual environment" as a way of helping patients to heal and participate more fully in their own healthcare. The article suggests simple tips, such as using the patient's name, affecting a pleasant tone of voice and making eye contact. Clinicians are also encouraged to be sensitive to religious or spiritual beliefs and to ask the patient what they need from you. Patients may be interested in alternate pain-control methods, such as relaxation techniques, rather than pain medication. Physicians often need to elicit this kind of information from the patient, who will feel more comfortable providing it if they feel accepted.
Clinicians sometimes forget that the doctor's office can be an intimidating place, and the gynecologist is often the only physician women see. In fact, Medical Economics cited a survey by Montefiore Medical Center in which more than half of the respondents ages 18 to 40 reported that they only see an OB/GYN physician for their healthcare. For a patient who only sees one doctor, a good patient relationship may be the key to maintaining their health for a large portion of their life. Physicians and nurses who embrace a holistic care model, which looks to patient dignity and strong communications, will likely see a positive impact — in both satisfaction and medical outcomes.
