When I was interviewing Centrica Care Navigators Hospice Medical Director Dr. Ron Seagle for this blog post, we kept getting interrupted, because so many people want to get his professional advice on what’s happening with their patients, their family members, and even themselves. He says there’s one piece of advice that’s a good guide for everyone he works with.
“The more patients understand that you’re listening, the more they are willing to work with you,” he says.
Experts on care
Dr. Seagle is an expert on care for patients with a life-limiting illness and a diagnosis of 6 months or fewer to live. As hospice medical director, he partners with our doctors, our nurses, and the other members of a patient’s interdisciplinary group (IDG) to determine the best plan of care for each patient.
Every day, the hospice doctors talk with IDG members and read communications from the team to learn what has happened to patients since the last check-in. Maybe there has been a change in their health, or issues with managing the symptoms of their illness. A lot of time is spent completing paperwork (which has increased over the last decade, Dr. Seagle notes). He has to sign “do not resuscitate” orders, death certificates, and other documents.
Every step of the process must be carefully recorded. A patient’s case has to be renewed after 90 or 60 days, depending on how long they have already been in care. It’s the hospice medical director or doctor’s responsibility to stay in close contact with all their patients.
Each patient has a “narrative,” a description of the patient’s overall health condition and how the patient reacts to their medication. It has to meet U.S. government requirements for reporting, specifically detailing the medication and other type of care a patient receives, along with a report on their health status. Doctors often write 200 or more patient narratives each month.
It’s not as simple as using medical expertise to judge what kind of treatment a patient should receive, though that’s definitely part of the process too.
“Physicians are part of a huge team,” Seagle says. “They help guide medical management. You need to have excellent interpersonal communication skills. Give patients advice and let them decide.”
The challenges of care
One of the challenges of medical care in hospice is that patients aren’t expected to live long — a life expectancy of 6 months or fewer is one of the defining characteristics of being a hospice patient. That can be difficult for doctors, who are trained to try to heal everyone. Hospice care isn’t about keeping people with a terminal illness alive; it’s about giving them a high quality of life in the time they have remaining.
Hospice doctors also get a different take on a patient’s care because they’re not working on their own — they have the other members of the IDG to give them perspective on the patient.
“We can reach out to the other members of the IDG,” Seagle says. “People are whole entities, not just their medical conditions.”
Face-to-face
Dr. Seagle says he’s proud of the work that he and the team at Centrica Care Navigators does. He tells the story of talking with an auditor reviewing patient care. When he said he saw the patient in person just a week before, the auditor was surprised that he actually made a face-to-face visit with the patient.
“We don’t want patients to feel they’re on the journey alone,” he says.
Dr. Seagle says being able to interact with patients and give them information about appropriate medical care helps them decide what’s right for them… most of the time.
“If they make a choice and they get better, you are an excellent doctor,” he says. “If they make a choice you (didn’t recommend), they’ll come back to you and say, ‘I should have listened.’ It works either way.”
For more on the care Dr. Seagle and the entire Centrica Care Navigators team provides, discover more here on our website, join us on social media, or call us at 269.345.0273.
