Brian P. Jacob, David C. Chen, Bruce Ramshaw, Shirin Towfigh (eds.) - The SAGES Manual of Groin Pain-Springer International Publishing (2016)

46. Patient Care Manager Perspective on Chronic Groin Pain…
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specialized fields. The patient must be informed of the various alternatives
for travel to and from the medical facility. Possible needs and alternatives
must be explored for convenient accommodations for patient and
family members before, during, and following the planned treatment,
test, or procedure at the medical center. The patient must be aware of the
specific paperwork required for employers, insurance providers, and others
with whom the patient is connected. The patient care manager and the
clinical team must be aware of and actively considering these needs in
order to provide all of the information needed by the patient as soon as
it is required. The viewpoint required for all of this is that of the patient.
The clinical team should be thinking, “What does the patient need?”
Obviously, the situation of some patients suffering with chronic pain
after hernia repair may be more complex than just one individual patient
seeking help. Manipulation, opioid abuse, secondary gain, and a number
of issues, both conscious and subconscious, may be present and can
inhibit the relationship between a patient and the clinical team and
inhibit a patient’s potential to improve.
It is very important for the patient care manager and clinical team to
confront any of these issues. But it is also important that the confrontation
be done with empathy and love, not with judgment. Instead of going
into a relationship with defenses up, our clinical team attempts to engage
every patient with empathy. However, if this is abused, we do put up
defenses as needed.
Shared Decision Process
As the medical team identifies the treatment options, there is likely to
be a need for some interpretation for the patient and the patient’s family.
While the medical team may well deal on a daily basis with medical
situations identical with or at least similar to those of a particular patient,
in most cases the patient has never dealt with such a situation before
and/or has difficulty understanding the options due to the presence of
chronic pain. The patient care manager and the clinical team must be
able to take the medical terminology and the explanation of symptoms,
outcomes, and ongoing treatment options and break them down in such
a way that the patient can understand their true significance. One cannot
assume that the patient understands; there must be patient and family
assurance based on the clear and concise communication process by the
clinical team. The patient care manager and the clinical team must learn
to think like the patient in order to provide the facilitation required to be