Parag Goyal, MD, MSc
Dr. Parag Goyal believes there’s a need to focus on older adults because there are additional layers of complexity that uniquely impact those with cardiovascular disease. Goyal is an associate professor of medicine at Weill Cornell Medicine, director of the Program for the Care and Study of the Aging Heart, and director of the Heart Failure with Preserved Ejection Fraction and Cardiac Amyloidosis Program
“As physicians, we are trying to help patients reach their health priorities,” says Goyal. “Traditionally, we have focused on longevity and preventing clinical events from occurring, but there’s been a movement recently to additionally incorporate patient reported outcomes: how they feel and preservation of function.”
For older adults with heart failure, Goyal says having multiple conditions and medications is universal. The number of medications a patient “needs” to achieve optimal health can be lengthy and burdensome, creating challenges especially when cognitive impairment is present.
“It’s a nice, illustrative example of the importance of PPC,” says Goyal. “This is where in-depth understanding of who the patient is, where they’re coming from, what matters to them within the context of what’s realistic and what’s reasonable given their health status, is critical.”
The challenge is, how do you practice patient-centered care in an efficient way?
“PPC is providing a scaffold to help make that happen,” says Goyal. “There’s an urgent need for such tools to facilitate an approach to care that I believe doctors intrinsically know are important, but just don’t know how to do it because of lack of training and/or lack of time.”
Using a patient-priorities aligned approach, Goyal has noticed a positive response from patients.
“I’ve had lots of patients comment on how our approach is unique compared to most clinical settings. It’s encouraging, and it pushes me to figure out ways of incorporating holistic, comprehensive approaches of care to all patients, outside the walls of our clinic, outside the walls of our institution.”