What Does "Patient-Centered Care" Mean When Treating TBI?


What does "patient-centered care" mean when treating TBI?


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[Dr. Heechin Chae] This is where I have to become from bunch of data to— I call it more humanistic approach. Sort of, what does this mean not to my patient, but to this person that I'm seeing today? Because as a physiatrist, I've been trained to learn that to some people, running is not a big deal. To some people, running is like their life. I mean, if they cannot run, that's like end of the world. That really has a huge impact in that person's life. Likewise, I have to ask that person, go back, "What I know about this injury is that it really affects the way you visually process information. That's why you're having memory problems." Actually—and also—but that sentence right there might make a big difference if somebody is a— if this is someone that spends most of their work reading computer. So, then I have to talk about, "Okay, what does this really mean?" Then come up with a treatment plan based on that. If this person's main deficit is balance, but he sits most the time sitting working with computer, that might not mean much to that person. Well, it might mean something, but not huge— not as impactful as the kind of test finding that I saw. So, that's what I mean by putting things together and developing treatment plan that's meaningful to that person. And I think we have, at least I've learned, that I tend to present what I think is best for the person. And, "Okay, this is what's going on, and this is our treatment plan." And he/she is going through a treatment, and they go, "Why are they trying to make me run when I never run in my life?" Something like that. "Why are they trying to make me like read all these things when all I do is just—I don't even—I even hate picking up the book. I mean, I rely on like this audio book nowadays." So those are the, in my opinion— it's like, not really knowing what the person wants and really sometimes frustrating the person really, and really a lot of times, unfortunately, they stop listening to you and sort of go through the motion, and they don't get really better. Even though they did get better, at least in my eyes, because we do all this testing again. It's like, "Great. You can run again." So it's, "Thanks, doc." And now focus on the things that really matters to that person.
Posted on BrainLine September 10, 2013.

About the author: Heechin Chae, MD

Heechin Chae, MD was appointed site director of DVBIC at Fort Belvoir and chief of the Traumatic Brain Injury Department at Fort Belvoir Community Hospital in 2011. He will become the director of the National Intrepid Center of Excellence satellite at Fort Belvoir in 2013.

Heechin Chae

Produced by Victoria Tilney McDonough, Lara Collins, and Ashley Gilleland, BrainLine.