Teaching Doctors to Care
August 19, 2004 | Read Time: 2 minutes
Photograph by Robert Glick
Debra Weissman, chief pediatric resident at Brooklyn’s Maimonides Medical Center, says she thought she understood many of the difficulties faced by the families of her chronically ill patients. But then she participated in a nonprofit program called Project DOCC (Delivery of Chronic Care) as part of her residency training and spent time at the home of a child with severe developmental and physical disabilities.
“With all the families I’ve met, I’ve been shocked about what they have to go through to get the care they get for their children,” says Dr. Weissman.
Project DOCC, now part of the standard training program for pediatric and family-care residents at 23 U.S. medical centers and one in Australia, began in 1994 at Long Island’s North Shore Community Hospital. Three mothers of chronically ill children founded the group as a way to deepen the relationships among doctors, patients, and families.
Each medical professional who participates in the program must attend a presentation by parents of five chronically ill children; interview the parents of an ill child using a 50-question script as a guide to get a complete history of the child’s illness as well as the family’s short-term and long-term goals; and visit the patient’s home, which gives the parents a chance to describe the impact of the child’s illness on the whole family’s day-to-day routine.
The interview with the parents provides a template to help the residents learn how to ask hard questions, such as whether the family has ever thought about limits on the kind of care they want to seek or made any end-of-life decisions.
Project DOCC has an annual operating budget of approximately $300,000, most of which comes from foundations. The United Hospital Fund, in New York, which has provided $320,000 since 1997, helped the organization get off the ground and expand.
Here, Dr. Weissman (left) talks with 6-year-old Meabeth Evers McLeer and her mother, Aelish McLeer, at their home. Doctors have not been able to ascertain a diagnosis for Meabeth, who has suffered from severe developmental disabilities since birth.
