Barry Singer, MD, is the director of the MS Center for Innovations in Care at Missouri Baptist Medical Center in St. Louis, Missouri. He shares how doctors can better guide treatment changes and encourage confident decisions.
Transcript
Yeah, I think it’s really important to be a good listener. We have to listen to the person in front of you in the exam room. What are they telling you? And if they think things are getting worse, you may look and your exam looks about the same and the MRI looks about the same. You say, “Oh, they’re pretty stable.” But listen to the patient.
The person with MS is going to tell you — let’s say when they walk — how far they could walk a year ago compared to how far they can walk now.
Does their foot start dropping after walking 50 yards or 100 yards? So I think it is important that we listen to them — to the patient. And so I think that can help direct transition of care.
And then I think it’s really important to have a conversation with the patient. What’s the alternative? If you’re on a modestly effective drug, maybe there’s a higher efficacy of medication that they could be switched to.
If you’re on one of the highest efficacy medications, is there another one in a different class that might work better, that has a different mechanism of action? Sometimes your hands are tied and there may not be another suitable option, but that’s part of the conversation with the patient, when you’re trying to make a decision.
