Patient-Centered Care

An Engaged Patient Who Knew Something Was Wrong

Her usual doctor was out of town when Beth felt a lump on her right breast and under her arm. As she sat in the doctor’s office listening to a new nurse practitioner explain why she didn’t think an imaging test was necessary, Beth knew something was wrong.

People in the medical profession—really anybody—can see where this is going, right? A cancer goes undiagnosed, the patient suffers, and the medical providers are sued.

But that’s not where this story goes.

Beth persisted. Although she felt somewhat disregarded this time, in her previous experience, the Granite Medical Group in the Atrius Health network had been attentive and thorough. This nurse practitioner was temporary and had never seen Beth before.

“You know your body and you just know when something is wrong,” Beth remembers. “You need to fight for it. I had this instinct about how I felt.”

Beth’s primary care physician (PCP) returned. She knew Beth well and knew she was not a medical worrier. If Beth felt something was off with her body, the doctor wanted to be sure.

After her PCP referred her for testing, Beth ultimately received the diagnosis of breast cancer. Did this episode harm her relationship with the practice that almost missed her cancer? Far from it.

“She was so great. She took the time to call me into the office,” Beth says today. “At least she didn’t call me over the phone. She’s very caring. She’s very thoughtful. She actually started crying when she had to tell me the news.”

The practice apologized for how the initial visit was handled. What impressed Beth even further was how the practice coordinated her care from there.

As a new mother looking to the future, Beth chose aggressive treatment. Click here to view a video podcast of her story.

Finding the Right Care With Help From a Great Team

It started with helping her select the right oncologist. There were going to be one-hour drives to Boston from her home in Braintree, Massachusetts, and many, many medical decisions. Her PCP’s philosophy is that encouraging patients to be engaged in care decisions and following his or her preferences leads to better care. Beth says patients need to find the right fit.

“She said she wanted to set me up with a great oncologist at Dana-Farber, someone she said would match my personality. It was just so nice that she was looking out for that aspect of it as well. She researched it. She asked other people, and she found the perfect match for me. It was amazing.”

Her oncologist respected Beth’s desire to be very aggressive with the treatment. A new mother who put her job as an art teacher on hold, Beth was looking solidly at the future.

But the immediate future would require coordination of surgeon, oncologist, ob/gyn, and primary care physician. This was another area where Beth’s PCP helped her receive the best possible care, after the rocky start.

“My oncologist and my primary care doctor always stayed in touch with everything that was going on. And my primary always saw the results, and she would actually contact me and congratulate me, or she would just check in with me on a regular basis. Even my OB doctor checked in.

“So I had all of these doctors and this network that all worked together so beautifully. They shared all my information, and everyone was aware, always in the loop of what was going on.”

Today, several years later, Beth is cancer-free. She ran the Boston Marathon to raise money for cancer research. Her husband has even joined the fund-raising, which has totaled $60,000 so far.

She believes the quick service recovery by her PCP should be a model for other providers after something goes wrong. A sincere apology, sharing concerns and emotion, thorough coordination of follow-up care, and staying close to the patient—listening carefully to her needs—are key.

“You’re so scared, and you’re going through so much, and you’re so sick that, for all these people to think of these things for you, just makes it a more human experience.”

It was the quality of the care following an initial stumble that left Beth with the impression that the practice is actually more thorough than most. If anyone needs proof that the care recovery was complete: Beth’s mom, dad, husband, and cousin have all transferred their primary care to her doctor since her diagnosis.


Tom A. Augello is the editor/producer of multimedia for the CRICO medical malpractice insurance program, a group of companies owned by and serving the Harvard medical community, with an established reputation as a leader in evidence-based risk and claims management. CRICO offers many resources for clinicians, including guidance for responding to adverse events.

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