OR WAIT 15 SECS
Adrienne Boissy learned early on in her career that being present in the moment for her patients was more important than trying to fix them.
It was 2 a.m. Adrienne Boissy, MD, was early in her residency-“the lowest man on the totem pole,” she says. One of the nurses on her team told Boissy that her patient needed her.
This was a young patient in her early 20s, remembers Boissy. The patient, recently diagnosed with multiple sclerosis, had a question.
Before heading to the patient’s bedside, Boissy, who’s now chief experience officer at Cleveland Clinic Health System, did a quick review of the medical literature on multiple sclerosis. The young intern wanted to make sure she was prepared for her patient’s questions.
She wasn’t prepared for this one: “Should I marry my boyfriend?” asked her patient.
This was a young woman who had support from a loving family and an ever-present boyfriend, says Boissy. Her patient wasn’t asking for relationship advice. She was grappling with the uncertainty of her disease; her patient wanted to know if she would be taken care of and loved.
That early experience taught Boissy what being a doctor meant to her. She realized she wasn’t in the business of “fixing” people. She discovered, instead, that her patients needed her to be “present.”
Today, Boissy is also a neurologist at the Cleveland Clinic Mellen Center for Multiple Sclerosis, where she has an active patient panel. She points to that early morning bedside visit as an intern because it guides her approach with patients.
They’re not just worried about their diseases. Boissy’s patients are wrestling emotionally and mentally with the changes neurological disorders, such as muscular sclerosis, have on their lives-changes that require them to adapt and change.
Take, for example, one of her patients who used to run marathons and can now barely lift their left leg. Or another patient whose spouse left after their disease had progressed.
Her patients need her to slow everything down. They need her to listen. To help them navigate their personal journey with their disease and how they’ll show up to those changes.
Boissy, who grew up in what she calls a dysfunctional family, studied neurology because she thought it would give her a “black and white” way to understand the world and why people act the way they do.
She was disappointed when she didn’t get the answers she was seeking. But her search has led her to ask more questions.
Such as, “Why do patients have to wait so much?”
“Our patients are tired of waiting,” says Boissy. “Waiting is so pervasive in healthcare. You wait for an appointment. You wait when you get there. You wait in the exam room. You wait for test results. You wait for the phone call back. You wait for the next appointment.”
That’s way too much waiting, in her opinion. And, thinking about her patients, Boissy adds that it’s not the wait itself. It’s what the brain does with the wait.
Patients wonder why they’re not being seen and what’s going on. They’re already worried about their health, and in the absence of a story, patients build their own narrative, she says.
These are patients who think the hospital has forgotten about them or doesn’t care-and they may just get up and leave for those reasons, explains Boissy.
Waiting really drives dissatisfaction among patients, she says. And it frustrates her that patients wait the same way they always have. “That really gets on my nerves,” she says. “In my dream state, I want to eliminate the wait. In this day and age, we need to predict the wait so patients can better plan their lives. We don’t want those [negative] narratives to overtake the brain.”
Cleveland Clinic is trying to understand wait times better, she says. It’s building predictive models around wait times to make it easier to predict when those waits occur. And the goal is to communicate that to patients and better manage their expectations.
Still, Boissy’s heartened by one aspect of the patient experience where patients are willing to wait. That’s with surgery. Patients are willing to wait two to four weeks for their own surgeon. “That’s a great testimony to the power of relationships,” she says. “Even when they’re offered another surgeon. I think that’s really insightful. It’s why we need to know our patients better.”
There’s no such thing as work-life balance, says Boissy.
“If we expand our view, it’s not just about balancing my clinical hat or my leadership hat or my mom hat,” she says.
Instead, she tries to embrace what she calls “the joy of imbalance.” For Boissy, that means being at peace. “Sometimes I’m a good clinician, a good writer, a good leader. Sometimes, I’m a good mom. Sometimes, I’ll be exceptional at one of those jobs. It’s hard to do, but I have to forgive myself…I make the most of the moment at work or at home.”
Knowing she gets to walk out the door at Cleveland Clinic also grounds her. “I’m at a hospital where people don’t get to walk out the door. Family members don’t get to walk out the door….That voice is in my head every day when I walk out of the building.”
And when she’s feeling particularly depleted from a stressful day? She watches funny videos of her kids. “It’s just to give me a little bit of perspective,” says Boissy. “That tough as it is, I’m very blessed. And I think laughter is critically important.”
Her career path has had its twists and turns. Boissy trained for many years as a ballerina. Then she taught ballet, managed a sporting goods store, and tended bar.
What changed her mind about pursuing her dream of dancing ballet professionally? The realization that a broken ankle could prevent her from dancing and impact her ability to provide for her future family, she says.
“I’m told I’m not a typical neurologist. I don’t know that I aspire to be one. What’s really important to me is to lead from where [I am].”
Aine Cryts is a writer based in Boston.