There have been many changes in health care over the last several decades. Solo physician practices have given way to large groups of physicians—often representing different specialties—who share patient care. Paper charts have been replaced by the electronic medical record, and physicians type much more than we write. Many patient care roles have been taken on by non-physicians, such as physician assistants (PAs) and nurse practitioners (NPs). The sense that the physician is “your doctor” may have been replaced by care teams that lack the continuity or trust that you had before.
Many of these changes in medicine have led to improvements in the quality of patient care, often by standardizing the way we treat illnesses. However, one of the other consequences of advances in technology and improved efficiency, in order to drive cost containment, is that the relationship between patients and their doctors has suffered. Doctors may not know their patients as well as they would like (or as well as the patients would like). They may not have as much time to spend with patients, to talk to them and get to know them. Even more unfortunate, they may not be able to help you make important choices when you need to make them. This can be frustrating for both patients and physicians.
At ProNobis Health, we provide you with both the factual information and the emotional support to help you make important decisions, such as choosing a nursing home, a physician, or a hospital, or even planning for care at the end of your life. All of our patient-focused information is freely available on this website. We want to help you make health care decisions in ways that your doctor may not be able to. We present both the best information and the important personal considerations in thinking about your values and what you want for your life. We want to help restore the art of medicine that considers not just the facts and the technology, but also who you—the patient—are and what you consider important. We respect your values and can help you integrate them into your health care decisions.
How We Can Help
Choosing a Nursing Home
Whether it be for yourself or for a loved one, choosing the right nursing home can determine everything from how well recovery goes to how happy and fulfilled life is. Short-stay nursing homes focus on recovery and rehabilitation, whereas long-stay nursing homes will often be where residents spend the rest of their lives. The goals, standards, considerations, and costs differ between short-stay and long-stay nursing homes. The resources at ProNobis Health can help you synthesize and organize the information you should be weighing as you consider nursing homes, including the facts about a particular facility and the things you value in your life. We also have compiled practical information to help you when visiting a nursing home.
Choosing a Hospital
Not every hospital is the same. Whether you are having a procedure or delivering a baby, you need to know about the hospital’s record. When you are admitted to a hospital you expect to get better, not worse. Unfortunately, at some hospitals you have a high risk of contracting an infection or leaving the hospital worse than when you were admitted. At ProNobis Health, our resources are aimed at helping you find and understand this information so that you can research and assess the hospital’s quality and safety record before you go there.
In addition to variation in quality and safety, there are many different types of hospitals, some of which may not be a good fit for you and your values. It is important to find out about these things in advance. Considerations such as whether or not residents and medical students will perform part of your procedure or be involved in your care, the availability of interpreter services, and rules in the hospital restricting certain procedures, may factor into your decision. Remember, it is your health and your decision to make.
Choosing a Physician
Physicians are as diverse as humanity itself. There are physicians of different genders; physicians who speak various languages and are familiar with different cultural groups; physicians who have been in practice for days, years, or decades; physicians who practice solo, in medium, or very large groups; physicians who are gregarious and outgoing and those who are reserved and shy. Not every patient is a good fit for every physician. Some of this depends on whether you are seeing the physician once for a minor concern, expect to have her care for you for a short period—such as during pregnancy or to replace your heart valve—or care for you for the rest of your life. There are lots of factors to consider when choosing a physician, and ProNobis Health can help you weigh them. Our informative guides help you think about what you value in a physician and suggest what questions to ask when you visit. To further help you make a good decision, we can point you toward the high-quality information that is available.
End-of-Life Care
Perhaps one of the most important aspects of life, but one of the least thought about and discussed, is what we want at the end of our life. Thinking ahead about what we want at the end of our life, what things we value, and what we consider to be a good death will help make sure those things are present. Things to think about include your feelings about life-sustaining interventions, hospice care, advance directives, and if legally available, medical aid in dying (MAID). For many, fear that our wishes will not be clear or will not be implemented at the end of our life can be a source of distress. At ProNobis Health, we want to help you think about some of the important aspects of care at the end of life, particularly how your values influence those decisions. We also want to help you make your values and wishes known so they can be best realized.