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A Collaborative Cure for Cancer

Posted By Joshua Fowler, Wednesday, May 15, 2013
Curing cancer, from a biomedical standpoint, is now possible, argues TIME Magazine writer Bill Saporito (2013), and is born from our philosophical beliefs about health care and from the practice of team-based, collaborative care. A bold claim, to be sure, but the truth of his claim depends on the meaning of the word "cure”. There are actually multiple meanings for the word "cure”. Saporito posits this: a cure for cancer is available, but is not simple to produce, nor easy to obtain. Still, it is possible, he says, and what makes it so is the harnessing of a collaborative approach by medical professionals from multiple disciplines.

In Saporito’s article, he writes that cancer "dream teams” can now effectively target and treat cancer, resulting in better and faster results that with more traditional biomedical care may not occur. What lays at the heart of these dream teams is collaborative care. Teams consist of professionals from various disciplines, all working together to help patients in a focused and targeted way. Each member has a purpose and a place and no corners are cut if it means even a chance at a slightly less favorable outcome for the patient. Saporito points out in his article the need to "upend tradition” in order to improve health care overall, not just for cancer. Today, people are living longer and chronic diseases (e.g., asthma, diabetes) are more common than infectious diseases (e.g., influenza, pneumonia). Traditional care that was focused on curing and removing disease may not be adequate for the long, drawn-out battles of chronic disease management. The need to change the way we treat diseases is growing, and it is time, as Saporito states, to part ways with traditional care that is only biomedical.

Perhaps there is something to glean from these cancer "dream teams”. Behavioral health care professionals, who offer biopsychosocial-spiritual care, are uniquely positioned to work alongside other health professionals in support of treatment. Teams of support professionals that work as well as the direct patient care teams that Saporito writes about already exist. At Duke University Hospital, Dr. Cheyenne Corbett, Director of The Duke Cancer Patient Support Program (DSPSP), leads a team of professionals from various disciplines. Though Dr. Corbett’s team is built to provide support rather than direct treatment for cancer, she and her staff take the same approach to health that the dream teams Saporito writes about use.
The need to change the way we treat diseases is growing


Recently, I had the opportunity to co-present with Dr. Corbett at a doctoral class of mine on childhood and adolescent cancers during which Dr. Corbett augmented my presentation with information on adult cancers, the main focus of the DCPSP. Further, she provided our class with an in-depth look at her team, how she operates, and why the DCPSP is accomplishing its mission "to create a humanistic environment for adults with cancer, as well as their family members, during the stress entailed in diagnosis, treatment, and after-care.”

Dr. Corbett, a trained marriage and family therapist, has a unique understanding of what it takes to support cancer patients to produce better outcomes for them. She and her team have the primary responsibility of acting as liaisons between patients and medical staff, providing hospitality to patients and families in exam rooms, and advocating for patients by helping them understand the resources available to them, including all of the services the DCPSP provides. If a patient wants family involved or a close friend to be nearby to provide support, the team works to make it happen. Professionals work as a team and check in with one another to ensure good care for patients. They look for gaps in patient care and work to close those gaps. The DCPSP is set up to take advantage of the collaborative view of problem-solving. Family is incorporated at every step along the way, and services such as family therapy are provided as part of care. Duke has a new cancer treatment center where the DCPSP is housed and even the building design was made to keep families together and to keep patients at the center of treatment.

Collaborative care, as Saporito writes, is becoming a vital part of healthcare not only between professionals but between patients and providers. As biopsychosocial providers, we should consider taking a look at how are we are encouraging family involvement and cross-disciplinary collaboration in our respective settings. If you are a patient or a family member, you may want to consider how you can advocate for cross-discipline collaboration in your treatment or the treatment of your loved one, and how you can stay involved in the overall treatment and support of your family member or friend who is a patient. These considerations allow us to examine if we are working in a way that is actually collaborative.

Saporito, B. (2013). The conspiracy to end cancer. April 1st, 2013, TIME Magazine. Retrieved from http://healthland.time.com/2013/04/01/the-conspiracy-to-end-cancer/


Joshua Fowler is a recent graduate of the marriage and family therapy masters program at East Carolina University.

Tags:  cancer  collaborative care 

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Opposites Attract: My Foray into Collaborative Healthcare

Posted By Annie Bao, Wednesday, March 27, 2013

Starting as a therapist in collaborative healthcare without any formal education or training in medical family therapy is like going on a blind date, which in actuality is your first date ever. This is along the same lines of where my journey began. From what I had heard of the potential for a tremendous (working) relationship to develop, it appeared to be a good path for me to pave as a clinician trying to carve out a rewarding career. My third-party knowledge of the system I was about to meet sounded like the ideal match in core beliefs and attitudes about how to support patients in their healthcare. I hesitated about my decision to walk into this situation with little knowledge about the process, but I was hopeful that there would be longevity in this adventure with something so innovative. 

Fear of seeming incompetent coursed through my system and excitement about how this may impact my future was an electrifying sensation. When I began training as a marriage and family therapist, most of my perceptions of its practice were derived from media portrayals (e.g., Frasier, Sopranos, & What About Bob?). When I was chosen to be a fellow in collaborative healthcare, I again relied on entertainment depictions (and published research, of course) to guide me through a general understanding of the environment I was about to immerse myself in. So armed with the encouragement of family, friends, and mentors along with my Grey’s Anatomy framework, I…was…ready.  

Collaborative healthcare was the perfect marriage for the pursuit of my aspirations
Something about collaborative healthcare has always intrigued me. Was it that I was the daughter of a physician, who spent my formative years with him, his partner, nurses, and CMAs at their practice? Was it that I myself had ambitions to be a physician that would help alleviate pains of ailing patients like my father could with such humility and grace? Was it my volunteer work at the hospital or with the underserved communities, limited from access to decent healthcare? Or was it having negative encounters with healthcare systems during the care of my loved-ones? Who can say, I’m certain that it is a combination of all of those factors and more. But, I know that passion for medicine and therapy live deep within me and collaborative healthcare was the perfect marriage for the pursuit of my aspirations. 


With no prior experience or training in collaborative healthcare settings, I was the least likely candidate to be chosen for a position to work in the field. So, I was admittedly apprehensive and doubted that I was capable of taking on the role as a fellow at the Chicago Center for Family Health (CCFH). As an outsider, I was stricken with feeling like a misfit who simply would not be accepted by this hierarchical medical system. Fortunately, my director and the other supervisors at CCFH were willing to take a chance on an eager, naïve, and very green collaborative healthcare consultant hopeful. They were the gatekeepers that I needed to grant me access into this specialty and the most unexpected champions of my abilities for the duration of my time with them. It was not lost on me that I had accepted a position with the well-respected, John Rolland, so I resolved to counter my insecurities with positivity and soak up all that I could from the experience.  

The collection of practical study of collaborative healthcare, frank process of my challenges, authentic feedback of my development, and enduring support of everyone affiliated with my fellowship have culminated into a notably defining time in my growth as a new medical family therapist. My unconventional introduction into this work was not a planned career goal, but some of what I learned about myself in the context of healthcare may seem typical. From my brief immersion, I developed the following way of being in fulfilling my objective to being an effective member of a collaborative healthcare team.       
All developing relationships that are worthwhile take time and commitment

Be yourself: It presents a platform that you can establish genuine connections with those you will be working with. This will ultimately benefit the patients that you all want to help.

Be confident in your expertise: Many times providers do not know what you have to contribute to the healthcare of their patients until you show that you have something to contribute to the healthcare of their patients.

Be humble in what you have to contribute: While you are educated in the psychosocial elements of an individual and their systems, physicians and nurses are educated in the biological aspects all the same. Ego has no place in patient healthcare.

Be collaborative: It is important for physicians and nurses to be transparent with you about their end of the providing healthcare, but you must also make an effort to communicate your interaction with the patients and their families.

Mantra: Engage individually, act collaboratively, and think systemically.

All developing relationships that are worthwhile take time and commitment from all involved to work together. I needed time to define and settle into my role as a fellow. My supervisors needed time to become acclimated to my personality (quirky, blunt, & vulnerable) and train someone unacquainted with collaborative healthcare, with a tendency to ask the most basic of questions. And, the residents and faculty needed time to visualize and integrate me into their system in a mutually beneficial manner. Eventually, I found myself busy in our newborn clinic (I learned how to use a transcutaneous bilirubin tool), conducting family sessions with multiple healthcare providers in attendance, and working extensively with physicians as a consultant to the psychosocial aspects of their patients’ health. 

In hindsight, this fellowship experience was colored with the most diverse of personalities and perspectives. The accomplishments of my work with patients was not mine alone, but was the direct result of intentional collaborative efforts by all of those I encountered throughout my time at CCFH. One of the most important lessons I learned was that integration of opposing views is actually a crucial factor to the success of our care of patients; after all, opposites oftentimes attract to make for meaningful relationships. 

  
Annie Bao is a licensed marriage and family therapist and a MFT doctoral candidate at Virginia Tech. As a fellow at the Chicago Center for Family Health, she gained experience as a healthcare consultant and therapist at the UIC Family Medicine Residency. She currently supervises MFT graduate students at The Family Institute at Northwestern and works in the Northwestern University and Advocate Illinois Masonic healthcare systems.  

Tags:  collaborative care  medical family therapy 

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