Lancaster Physician Spring 2017 - 26

L A N C A S T E R M E D I C A L S O C I E T Y.O R G

Patient Advocacy

PENNSYLVANIA ORDERS FOR

Tools to Facilitate Communication and Understanding
Between Patients and Health Care Providers

CHRISTI ANN STEWART, MD
LG Health Physicians - Geriatrics

e've all been there. Sitting across the room from a
patient, counseling them on lifestyle modifications
or screening examinations. Wondering how to
bring up and talk about the "bigger picture." So
often in medicine, providers focus on tangible, measurable goals.
We are comfortable with numbers and tests, things we can measure
with certainty. But are we are doing a disservice to those who trust
us with their care by not framing these things in the context of
what's important to each patient as a person? How often do we
miss the health and well-being of the forest when we focus on the
individual trees?

the here and now and what defines quality of life today. In this day
and age, when it feels like there are always more tests and scans
to be run and more medications to be given, it's easy to be swept
up in the tidal wave of medical progress. It's challenging to take a
step back, assess what is really important to the person sitting in
front of you, and tailor medical recommendations appropriately.
Hence, the POLST (Pennsylvania Orders for Life-Sustaining
Treatment). Printed on bright pink card stock for easy recognition
by emergency care team members, the POLST is meant to serve as
a living document that reflects a conversation between a provider
and a patient regarding the medical care an individual desires at
the time the document is completed. It is not meant to replace a
living will or power of attorney, but rather reflect how aggressive
an individual would like the health care community to serve them
in the case of illness. To be valid, a provider and a patient must
sign it, and it is to be kept with the patient at their home so it's
accessible to emergency medical teams. It defines four questions

Living wills and advanced directives are valuable tools. They
allow important conversations to happen between family members
and friends about what quality of life means and how they want
to spend their final days. But these documents are framed "in the
event of a terminal condition." They focus on the distant future,
on unseen and unforetold events that feel very far away. They miss

LANCASTER

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