The Virtue of Patients
1. Peck J. The art of surgery. Am J Surg. 2004;187(5):569–574.
2. Paullin JE. Medical citizenship. The Georgia Review. 1947;1:445–451.
It is the individual patient who we treat, not the disease.1
We are all familiar with the adage, “Patience is a virtue,” but in the field of medicine, “patients are a virtue.” Yes, without patients we would have little to do. In wound care, patients seek our help to improve or cure a variety of maladies usually related to a poorly healing wound. When patients are first seen, we obtain some relevant information called a history, then we focus our attention on the “hole in the patient.” Within a matter of minutes we have collected a significant amount of information about the wound—its size, its location, and so forth. During this time, we have been formulating a list of possible causes for the problem and potential therapies. Then, we push out our chests and announce our diagnosis to the patient and the treatment we propose. While the process is all well and good, we have forgotten one main piece of this medical puzzle—what does the patient think about the problem and proposed treatment? Most people come to us for help with a specific wound problem. Drainage may be preventing the patient from attending social events, or perhaps the wound is painful. Are you particularly interested in knowing what it is about a wound present for six months that suddenly convinced this patient to seek your advice? Many times we overlook the patient’s integral role in our wound care team.
The mission statement of the Association for the Advancement of Wound Care (AAWC) is “To build a collaborative community of multidisciplinary health professionals, students, retirees, corporations, patients, and their caregivers around the world to facilitate optimal care for those who suffer with wounds.” I expect that almost everyone reading this has overlooked the part about “patients and their caregivers” being part of the wound care team. For the “team” to function efficiently and effectively, all parties must be involved. Patients and caregivers need to have a network of like-minded individuals to provide support and resources. This would allow them to be more involved in the process of treating the wounds in addition to being better educated about their problem and the necessary treatment. Today, nearly all diseases have support groups, so why not wound care?
The AAWC has a Patient/Caregiver membership category. In 2008, of the 1697 AAWC members, only 12 were in the Patient/Caregiver category. This can mean one of two things: We either have very few interested patients and caregivers, or we are doing a lousy job of providing the support and resources that could benefit this group. At the most recent Symposium on Advanced Wound Care, AAWC President Dr. Bill Ennis, issued a challenge—to actively recruit patients and caregivers to join the organization. He even recommended that we consider sponsoring patients for membership. At the same time, the AAWC Board of Directors has pledged to give this membership category the utmost attention to involve patients and caregivers in the AAWC. Such interaction will foster discovery of what patients and caregivers need, and facilitate a support network to meet these needs. Mr. Charles Rakis, a patient of Dr. Ennis’, gave an inspiring speech that should convince all of us to work to meet the needs of our patients above and beyond those of debridement and bandaging. If you are interested in supporting a patient through this initiative, please contact Dr. Bill Ennis, Ms. Tina Thomas, or me through the AAWC website (www.aawconline.org).
Remember, many times more can be accomplished by treating the patient rather than the disease.2