Summary Writer: Cynthia Yang
Editor: Bruce Way
Interviewee: Chris Dalton
James talks to Dr Chris Dalton about communication and patient-centred care. Patient-centered care refers to managing patients according to their needs, wants and capabilities, rather than according to the interest of the doctor or hospital.
Chris Dalton graduated from the University of Sydney in 1980 with honours and worked in surgical training as a resident and registrar in Sydney. He then trained in obstetrics, paediatrics and anaesthesia obtaining the Diploma in Obstetrics from the Royal Australasian College of Obstetricians and Gynaecologists. After working in rural general practice for a few years, Chris returned to surgical training and obtained the Fellowship of the Royal Australian College of Surgeons in ENT surgery in 1993.
After completing post-surgical fellowships in laryngology with Bruce Benjamin in Sydney and head and neck surgery with David Howard and Valerie Lund in London, he worked at Westmead Adult’s and Westmead Children’s Hospitals as an ENT surgeon, with a particular interest in head and neck oncology and paediatric otolaryngology. Chris also practised in the private sector as an ENT surgeon during this period.
He joined Serco in 2012 as a Medical Director, working in business development, clinical governance and the development of new models of health care delivery, especially involving coordinated care. Chris has also completed a Master of Public Health at the University of Sydney and is currently enrolled in the Master of Biostatistics program there.
Chris joined BUPA as a Medical Director in 2014, where he has roles in claims management, development and implementation of policies for health insurance, clinical governance for BUPA’s health provision services and designing and supporting the clinical aspects of BUPA’s new business development. Currently he is involved in a data analytics project to gain deeper clinical insights into Bupa’s datasets.
Chris also serves on committees for the Prostheses List and the MBS review for the Australian Federal Government.
With Dr Chris Dalton, BUPA Medical Director and Ears Nose and Throat Consultant, Sydney, Australia
Good communication is a fundamental skill for any doctor.A lot of complaints arise from communication problems, when patients do not hear or understand what the doctor says, when the doctor fails to state important facts and when there is a lack of rapport between the doctor and patients or their families.
Patient-centered care refers to managing patients according to their needs, wants and capabilities, rather than according to the interest of the doctor or hospital.
Patient-focused care is more episodic, dealing with a specific problem for a particular patient. Its emphasis is on long-term plans and preventative strategies.
Hospitals are large, dynamic organisations. Often the patient gets forgotten.Patients have multiple issues, needing numerous specialty inputs and outpatient follow-ups. The role of junior doctors, in addition to managing the immediate issues, include follow-ups, booking appointments and ensuring sound discharge planning.
Case 1 – You are the orthopaedic intern. An 80-year-old lady has been admitted after a fall and sustained a neck-of-femur fracture. She normally lives at home independently. Now she is planning for discharge post-surgery (open reduction and internal fixation). The nursing unit manager asks you when the patient is going home. The patient wants to go home, but her family thinks she needs respite care. The registrar and consultants are in theatres. There has been anortho-geriatric consult requested, but this may be days away.
Case 2 – You are working in the Emergency Department. A young male with a history of IVDU and benzodiazepine dependence presents to you, requesting for a benzodiazepine script. This is on a weekend and his script has run out. He has had benzodiazepinewithdrawal seizures and his usual doctor is unavailable until Monday.
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