Inspired by Atul Gawande’s book, Being Mortal, and the 2018 Benjamin Menschel Distinguished Lecture at Cooper Union on April 25th.
The pharma industry talks a lot about patient-centricity; however, it has yet to truly make its voice heard. When the public considers pharma, they probably conjure up images of CEOs and Wall Street before they think of the prescription therapies that are so indispensable to us all. If pharma wants to make meaningful steps towards patient-centricity, then patient-physician communication is a huge opportunity.
As a profession, physicians aren’t best known for their communications skills. This comes as no surprise given the emphasis on what goes into – and gets left out of – their training. Using actor simulations to practice tough conversations has only recently been taken up by medical schools. This means many physicians are practicing medicine without such training.
Why does this matter? Imagine that someone you love is diagnosed with metastatic cancer. Perhaps, like me, you don’t have to imagine but merely remember. My grandfather was a retired doctor of hematology and internal medicine in Washington, DC when he was diagnosed with metastatic head and neck cancer.
The oncologist asked what we wanted to do about treatment: did we want radiation, chemotherapy or a targeted therapy in clinical trials? With my grandfather and father both being physicians, you might think that this question wouldn’t have been too hard to answer … but it was. We agonized over what to do. My grandfather tried chemo and, when that failed, said he was done with treatment and ready for the disease to take its course. He then changed his mind and decided to take the targeted treatment. What was going on? In spite of the oncologist laying out all the options, we still couldn’t decide.
It wasn’t until I read Atul Gawande’s Being Mortal that I understood what was missing. We didn’t just need information from the oncologist, but rather counseling and guidance. We needed to have a conversation about priorities: What were my Grandfather’s hopes and fears? What trade-offs was he willing, and not willing, to make?
Every year millions of families like ours go through this experience. Without conversations about priorities, these people may not be able to live and die on their own terms. As Gawande says, we experience life as a story and the way a story ends matters. To the physician, the risk comes in the form of emotional burnout.
Conversations about priorities are challenging and even painful, which is why patients and physicians need help. Gawande’s group and others like it (e.g. VitalTalk mentioned at ASCO 2017) educate physicians on how to have these challenging discussions. Training like this is a worthwhile investment for pharma.
In my work at Hall & Partners, we focus on building relationships that matter and being the voice of the customer to our clients. What pharma customers – both physicians and patients – need right now is an investment in communication education.