The benefits of referring patients to other patients

When doctors are stumped by challenging clinical cases, they often refer patients to specialists to assist with the diagnosis and management of the patients’ conditions.

Aniruddha Malpani, MD“Doctors can learn a lot from expert patients.”
-Aniruddha Malpani, MD, medical director of Malpani Infertility Clinic in Mumbai, India

While specialists can be very skilled at making the correct diagnosis, they often do not delve very deeply in helping patients learn to live with their diseases. This is not the specialists’ core competency, nor should it be.

However, after the diagnosis has been made, patients’[s2If !is_user_logged_in()]…

[/s2If][s2If is_user_logged_in()] lives need to carry on—and they often are unsure where to turn for help.

For example, let’s look at a young woman who goes to her family physician complaining of blurring vision. The physician dutifully refers her to an ophthalmologist, who then sends her on to a neurologist, who performs the necessary tests and ultimately makes the diagnosis of multiple sclerosis (MS). The doctors pat themselves on their backs for having arrived at the correct diagnosis so efficiently. The patient is grateful that at least now she knows what her medical problem is. However, she still has to learn to live with MS, and learning how to cope with a chronic illness is often the most difficult aspect for patients.

Key Point: When you make connections between patients who have similar diseases or conditions, you provide invaluable support and advice to the newly diagnosed patient. In addition, the expert patient benefits by being able to give something back to someone going through the same experience.

Unfortunately, this is something about which none of the patient’s doctors is well-informed. The neurologist knows a lot about demyelination and how this affects nerve function—but he cannot teach the patient much about how to come to terms with her illness and how to manage her activities of daily living. So who does the patient turn to in order to learn how to deal with her fatigue? With a cranky child when she isn’t feeling well? Arm weakness? Her fears that she may become wheelchair bound?

The best source of this type of expertise is not a doctor at all; it’s an expert patient—someone who has lived with MS for many years and is willing to share his or her hard-earned wisdom and experience. As long as you respect the privacy and wishes of both parties, you can make a difference in your patients’ lives by connecting them in this way. The newly diagnosed patient will benefit from the knowledge and experience of the patient who has been living with the same condition for some time, and the expert patient will feel a sense of accomplishment for lending the support.

Good doctors have made these types of connections informally for many years. It’s been proven that support groups are a great way of helping patients to cope with their illness. In addition, it’s now possible for patients to take part in online support groups; you can keep a list of ones that are legitimate and beneficial and refer patients to them as appropriate.

Doctors can learn a lot from expert patients. Thus, while a diabetic specialist may know a lot about the metabolism of insulin and how to program an insulin pump, she may not have a lot of real-world advice for the diabetic patient about staying on his eating plan when attending a marriage or going out for a holiday. However, a patient who has “been there, done that” could be an excellent resource for the newly diagnosed diabetic. If that advice helps the patient follow your treatment plan, everyone benefits.

Your newly diagnosed patients who fear the unknown can glean pearls of wisdom from expert patients. The expert patients will be empathetic; and their advice is likely to be practical, as it is based on their real-life experience rather than a clinical textbook.

Connecting patients with each other is an important way to create moral support. These connections don’t diminish the patient’s need for the clinical information and advice that you provide—instead, they complement and reinforce your efforts.

Aniruddha Malpani, MD Dr. Malpani is medical director of Malpani Infertility Clinic in Mumbai, India, medical director of the HELP-Health Education Library for People, and author of a physician and patient education blog. He is an angel investor in Plus 91, which offers customized Web sites for doctors.


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