In today's episode, Ryan and Allison talk about family meetings, in line with last week's podcast about end-of-life care, and specifically how you're going to communicate that during a family meeting and how to best set up family meetings.
During residency, Allison spent a ton of time on a project all about family meetings and end-of-life care. Ryan and Allison believe that giving this kind of education to you will be very helpful as you're about to embark on your medical career.
Here are the highlights of the conversation with Ryan and Allison:
- Day 3 of internship in the midst of taking care of different patients
- Inherited a very sick patient who recently came out of the ICU
- Getting overwhelmed by everything going on with her patient
- The family wanted to have a meeting
- Allison recognized she needed help in leading the meeting so she went to her junior resident to ask for help.
Tips to Running a Successful Family Meeting:
Do your homework. Make sure you know which patient you're talking about (name, where they are). Refresh yourself on what recently just happened with the person.
Get with everybody else that has been taking care of the patient.
Medicine is a team sport. Understand that it's not all about you. There are nurses, social workers, other physicians, and other specialists that are taking care of this patient. So reach out to them and get information from them about the family.
*The patient's nurse must always be a part of the family meeting.
They are spending a huge percentage of their day with that patient so they may know the family so much better than you do and understand the finer details.
Think about privacy.
Although a lot of hospitals now have a lot of dedicated family rooms set up, be careful not to have a big conversation or update with family members next to other people.
At the start of the meeting, inquire about their understanding of what's going on with the patient.
One of the pitfalls people make when they go into a family meeting is they rush ahead and talk about what's going on while the family doesn't understand what's going. Make sure you're aware of what they know so far so they don't get confused.
Avoid the medical jargon.
Don't be throwing out medical jargon because the family won't have an idea of what you're talking about.
Goals of Care
This is an extremely crucial concept although it doesn't necessarily have to enter into every family meeting. This is a meeting about addressing the goals of care. Listen to Session 69 and know more about this. Once you've clarified the family's understanding, talk about the goals of care at this point.
Listen and answer questions.
Make sure to listen to the patient or the family member. Listen and pause to get a feel of what they're thinking and feeling. Make sure the family is understanding what you're saying. Repeat anything if necessary.
Guide the family on this journey.
You're there to provide information to them and help them make a decision that will help them as to the next steps of their loved one's care, be it comfort care or changing the goals of care or discussing a new treatment.
One last thing…
Understand the wishes and desires of the patient as far as DNR/DNI.
We all have living wills, regardless of age, because life is unpredictable. A few patients will come into the hospital already with a healthcare proxy or with advanced directives. So be aware of those things.
Some pieces of advice for those transitioning into internships:
- Medicine is no longer paternalistic. You have to come up with the best decision for the patient based on your knowledge, the family's knowledge, and what's best for the patient.
- Don't offer unreasonable things which are not appropriate. Just because you can doesn't mean you should.
Links and Other Resources:
If you need any help with the medical school interview, go to medschoolinterviewbook.com. Sign up and you will receive parts of the book so you can help shape the future of the book. This book will include over 500 questions that may be asked during interview day as well as real-life questions, answers, and feedback from all of the mock interviews Ryan has been doing with students.
Are you a nontraditional student? Go check out oldpremeds.org.
Free MCAT Gift: Free 30+ page guide with tips to help you maximize your MCAT score and which includes discount codes for MCAT prep as well.
Hang out with us over at medicalschoolhq.net/group. Click join and we'll add you up to our private Facebook group. Share your successes and miseries with the rest of us.
Check out our partner magazine, www.premedlife.com to learn more about awesome premed information.
Next Step Test Prep: Get one-on-one tutoring for the MCAT and maximize your score. Get $50 off their tutoring program when you mention that you heard about this on the podcast or through the MSHQ website.
Listen to our podcast for free at iTunes: medicalschoolhq.net/itunes and leave us a review there!
Email Ryan at firstname.lastname@example.org or connect with him on Twitter @medicalschoolhq
Tweet Allison @allison_mshq.
Subscribe for Free
Listen to Other Episodes
Leave us a Review and Rating!
Just like Yelp reviews or IMDB ratings help you choose your next restaurant or movie, leaving a 5 star rating and/or a written review is very valuable to The Premed Years. It allows us to be able to share our information with more people than ever before.
I am so incredibly thankful to those who have recently gone into our listing in iTunes to provide a five start rating and a written review of The Premed Years.
Subscribe and Download
Android/Mac/Windows – You can download DoubleTwist and use that to manage all of our past and future episodes
Please help us spread the word!
If you like the show, will you please take a moment to leave a comment on iTunes? This really helps us get the word out!
Crush the MCAT with our
MCAT Secrets eBook
DOWNLOAD FREE - Crush the MCAT with our MCAT Secrets eBook