Dr Robert Carlson on Balancing Efficiency and Patient-Centered Care

Oncologists need to ask patients the right questions and truly listen to the answers, but they must then balance the individuals’ goals with the practice’s efforts to provide consistently efficient cancer care to all patients, according to Robert W. Carlson, MD, CEO of the National Comprehensive Cancer Network.

Transcript (slightly modified)

How can oncologists change their practices to make care more patient centered?

Having a practice that’s patient-centered is a challenge, and it’s a challenge because of the many different forces that oncology practices face in terms of efficiency of care, cost-effective care, staff limitations, more patients than there are oncologists, and that problem is going to simply get worse. But I think the best solution to try to do the best job we can is to listen to patients. Not just talk with them, but actually listen to what their needs are, what their desires are.

Patients are a very heterogeneous group, and different patients have different needs. They have different fears. They have different goals. And the questions have to be asked: what is important to you? What are your fears in this situation? What are you trying to accomplish? How can we help you do that? What are we not doing for you that we need to do for you? Ask the questions and then carefully listen to the answers and try to accommodate the patients as best you can.

It’s also, one of the other things in medicine that’s a struggle in terms of trying to be responsive to individual patient needs like that, is that we know that the safest, most efficient way to deliver cancer care is to deliver the same cancer care many, many times, to not make an individual plan in detail for each individual patient. So it’s interesting that some of the safety issues and the methodologies for delivering care in an efficient, safe, reproducible way are actually to some extent in tension with the individualized patient-focused care. But we somehow need to find the sweet spot, so that we can really accommodate both of those goals.