By Dr. Blaise Mooney
Medical Director, Richard M. Schulze Family Foundation Outpatient Center at Moffitt McKinley Campus
As a physician, taking care of patients with cancer in the era of COVID-19 has been a challenge. Testing for COVID-19 has added steps and new worries for patients and their families.
Keeping our staff safe has added multiple steps to the simplest of tasks, like entering a building. The word "doctor" literally means teacher. In addition to medicine and lifesaving procedures, successful treatment involves educating patients about their disease and how to avoid COVID-19.
Masks, visitor limitations and social distancing have been helpful to stop the spread of diseases. These changes have saved lives. However, those life-saving actions have forced us to change the way we teach our patients and their families about their cancer. Cancer is a complex disease.
It carries with it a heavy emotional burden. For many people, it is the first time in their lives dealing with a potentially deadly or life-altering illness. Early in the diagnosis, patients and families are faced with numerous tests and results.
The amount of new incoming information and stress of having cancer can be overwhelming. I have often found this to be true. In my practice, I rely heavily upon family members and caregivers to make sure that the diagnosis and recommended next steps are clearly understood.
To do this, I pay close attention to facial expressions.
This past April, I was explaining the results of a breast biopsy to a patient. To protect our patients and staff from COVID-19, our visitor policy restricted her husband from attending the appointment.
The conversation was difficult, as was trying to explain to her in person while her husband listened on a cell phone. Her mask covered her frowns but did not hide her tears. I wanted to comfort her and her husband, but I couldn’t. We did our best.
I apologized for the impersonal nature of our encounter. As a doctor, I felt very inadequate and decided to make changes. The next time, I asked the patient if she would like to go to a private area with her family so we could talk to everyone.
I used my laptop and camera, and took my mask off so they could see my face. I was also able to show them images, which helped explain the extent of her cancer and what she was facing. As we talked, her family was next to her providing comfort and asking questions. I was able to layout the next steps.
I ensured that they understood our plan for her specific type of breast cancer and that a team of Moffitt doctors and nurses would be taking care of her. I knew she would have more questions, so I made sure she understood how to use Moffitt’s Patient Portal. We set up virtual visits with members of her health care team, allowing them to safely communicate and address her concerns with her family listening and taking notes. This was all done safely with faces visible.
Cancer raises questions and waiting for the answers is excruciating. Delivering clear information is vital to helping patients fight and cope with cancer.
COVID-19 forced us to change the way we communicate and how we teach our patients. As health care workers, we care deeply for every patient facing cancer. We will find ways to improve the delivery of clear information and teach our patients and their families.
I look forward to the days of in-person conversations again, but until then, I will strive to deliver clear information as safe as possible using every means available.
Content for this story is from PARTNERS winter 2020; a newsletter of the Patient and Family Advisory Program.