I need hope too: Redefining goals based on care recipients’ wishes in value-based care

By | November 29, 2016

I spent the first thirty years of my life in preparation of serving others as a physician. Now, I often ask myself why. The answer is easy: I wanted to help others.

I wish it was that simple.

In order to feel fulfilled, I deemed success as helping others. But for years I defined helping others as curing them, as getting them better. Now I’m not sure those I’ve tried to help would agree with my definition. I never took the time to understand what helping someone else meant. I never asked “what does success look like to you?”

I recently read a book From Breath to Air by Paul Kalanithi. It made me think about my role as a provider and relationship with my patients from a whole different perspective. One of the most meaningful lines in the book is when the author comments that “doctors need hope too.” This statement hit me like a ton of bricks, because I realized the reason I was so focused on getting my patients better, as I defined it, was because that’s how I got my hope. What drove me was the hope my patients would improve, so I needed to do everything in my power to make that happen, regardless if that’s what my patient wanted. But I never asked, because I was too focused on filling my own needs.

This ah ha moment gave me insight into what I believe is a major issue in healthcare. We as providers need to realize that our success is delivering to those we serve what they want and what they believe is success. And to them, success might be very different than what we envision. For example, a goal of one of my patients might be to avoid harm at all costs against the possibility of improvement, contrasting with my bias towards treating based on my hope needs. But, if I shift what I define as success to what my patient wants, then I might come to a different conclusion while still filling my hope bucket. When this happens, a relationship forms and fills my emotional needs while also providing value to my patient.

As healthcare begins to shift to a model of value, where cost is a major component, what I do as a provider drives the value equation. If my decisions are based solely on what I deem to be success for me, I’m not truly delivering value for those I serve.

To create value models in healthcare, we need to be attuned to the emotional dynamics of both the consumers and providers of healthcare services. If we truly want to change healthcare, we need to ensure that we provide for the needs of those we serve and for those we ask to serve. By refocusing the definition of success by including the patient in true communal dialogue, not only will we be more reverent to their needs, but we will also give hope to ourselves.