Claire Davenport, MD, MS – Assistant Professor, Geriatrics & Bioethics, Brookdale Department of Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai
I first started to do Patient Priorities Care (PPC) on my own during the pandemic. I learned a lot on this journey, things that I did not expect. I began by using the original conversation guide, selecting one or two patients to call prior to their upcoming visit that week. I stuck to the script, took my time, usually between 20 and 40 minutes. I felt I was learning something new – a new way of speaking, a new language, a new skill. My very early patients were gratified and felt deeply listened to – they would say, “you’re asking me questions I’ve never been asked before”.
I just couldn’t help but continue. In this early phase, I quickly realized that I had been practicing medicine in the dark. In residency, my colleagues would joke that if they wanted to know the social history for any patient they would “just ask Claire”. An intuitive part of me felt that knowing a person’s story was not only their path to trust and rapport, but also a meaningful device for diagnosis and treatment. However, at that time, I didn’t know how to operationalize this understanding. As I was beginning practicing PPC I was remembering who I was perhaps always meant to be as a healer.
I learned that PPC is an operationalized way of arriving at the single unifying guide, it supplied all the necessary supporting information, what that person’s willing and able to do to achieve their best life. I realized The One Thing helped to create harmony in every visit, no matter how complex it became. When I felt ready, I started practicing priorities identification during my initial clinical encounters with new patients using the MyHealthPriorities.org website.
As you start to implement PPC, your way may look very different from mine, and that’s okay. As more of my patients had their priorities identified, I truly began to understand how values drove their health, their lives, their motivation. This is a shift from how we’re taught to practice. It relies on everything we’ve learned up till now and calls for even older parts of us, the parts that know how to connect with people and offer careful attention when somebody speaks from their heart.