Patient-Centered Care: Interview with Registered Dietitian Cathy Conway

By Shantika Bhat, VG Intern

Shantika Bhat is interested in neurological
diseases and how to care for patients. She interviewed Cathy Conway, a
registered dietitian who works with patients who have developmental and
intellectual disabilities. 

Playing the role

Something
that always comes up in the medical field is that fear of preconceived notions
of a doctor’s role. Some patients will be scared that the doctor will be
telling them what to do or that the doctor doesn’t want to listen to them.
Oftentimes it’s not talked about how intimating a title can be for patients and
so Cathy wants to break down those feelings by playing her role in a manner
that’s focused on active listening.

“It
is really important to respect an individual and hear what they are saying,”
says Conway.

As
a registered dietitian she gets patients all the time who will believe that she
will be telling them what to eat and what not to do, however, she doesn’t. She
listens and asks them “What do you think?”

“I
call it peeling an onion. You want to get to the real issue by asking the
questions and repeating what my patients tell me.” For example, Conway had a
patient who had Type 2 Diabetes and their A1C was high. Conway asked the
patient questions and made the patient realize what they were doing that wasn’t
healthy without directly saying it. I learned from Conway that making your
patients realize what they did wrong is more effective than telling them what
they did wrong. At the end of the day it’s the patients who make the decision
so you have to make sure they realize what they need to fix.

Working with Intellectual and Developmental
patients: Patient-Centered Care

I
thought when working with patients who have intellectual disability that health
professionals would need extra training. My perception has changed a little bit
after talking with Conway. I went into this thinking that there must be extra
training for many disabilities; however, Conway says she learned the most from
experience over time. I knew that with a spectrum of all of these disabilities
that a training will not be enough for you to be able to provide the best care
for them. It is all case by case which is why Conway treats her patients using
Patient Centered Care. The Institute of Medicine’s
article Crossing the Quality Chasm: A New
Health System for the 21st Century
defines patientcentered care as
“Providing care that is respectful
of, and responsive to, individual patient
preferences, needs and values, and ensuring that patient values guide all clinical decisions.”

“You
can’t put everyone in a box,” says Conway.

Active
listening is so important because it helps to really connect to the patient so
that the dietitian or doctor can help them best. Active Listening is a
technique used to connect and engage the speaker and listen in conversations.
Conway recommends that everyone going into the healthcare field learn Patient-Centered
care and active listening.

 Diets

Conway
advocates for diversity and trying something new. In New York they passed Bill S1471A/A4072, which requires hospitals to make
plant-based meals and snacks containing no animal products or by-products that
are nutritionally equivalent to other menu items available to those that
request them. The bill also requires hospitals to list the plant-based options
on all written materials and menus. One of Conway’s patients was in the
hospital for a week and got to try the menu with these foods he wouldn’t have
tried elsewhere. And now this patient orders plant-based foods such as quinoa on
a regular basis on his outings.

“You
should try different foods so that new foods can be added to your regular diet.
The more exposure the better,” said Conway

For
information that may be helpful to food services, see: https://www.vrg.org/fsupdate/index.htm