Why we built a clinic around being informed
On the founding decision to make clarity, not just compassion, the operating principle.
By Dr. Sarah Mitchell
When Marcus and I left Brigham and Women's to start BFC, we did not begin with a clinical hypothesis. We began with a sentence we kept hearing from patients who had come from somewhere else: nobody told me what was going on.
It is a strange sentence to keep hearing, because the people they had come from are not bad clinicians. They are good clinicians working inside a system that was not designed to keep the patient informed. The reports go to the doctor. The decisions get made in a room the patient is not in. The patient hears about it later, sometimes much later, sometimes not at all.
We built BFC the way we did because we believed the operational backbone of a clinic — how results travel, who sees them when, who writes the plan, who signs off on the plan — is what determines whether the patient is informed. Compassion is the easy part. Compassion is also the part that does not change anything if the patient still does not know what is happening.
Three years in, I think we got the priorities right. The patients who tell us what they value are not telling us about a kind word or a soft chair. They are telling us they have a written plan. They know what is next. They know who to call. The dignity of being informed turns out to be a thing you can deliver, if you are willing to redesign the clinic around it.