Book Club: Every Patient Tells a Story

Picture of the book Every Patient Tells a Story by Lisa Sanders, M.D.

One of the first things every doctor and nurse learns in their education is the importance of collecting subjective and objective data. It begins to lay the foundation for how the treatment plan should begin. However, in today’s healthcare system, where there are many patients and too few healthcare providers and nurses, the time needed to listen to the patient’s story may be cut short.

Have you ever been sitting in an emergency room or medical office, feeling awful? The healthcare provider walks in, barely makes eye contact, and within a minute orders an X-ray or MRI, or prescribes a medication and moves on to the next patient, not even giving you time to ask questions or talk about your symptoms. You leave feeling unheard, wondering if the provider understood what was wrong.

Every Patient Tells a Story

This rushed, technology-driven approach to diagnosis is becoming more common in healthcare—but is it the best way? Dr. Lisa Sanders argues it isn’t in Every Patient Tells a Story. She takes readers into the world of medical diagnosis, showing how a patient’s story is often the key to uncovering the real problem. Through gripping real-life cases, Sanders illustrates the art of listening, observing, and piecing together clues that no test can reveal. The stories showcase medical mysteries and emphasize crucial lessons about what is needed in medical training to equip doctors with the necessary skills and open-mindedness to avoid relying too heavily on lab tests and technology. She warns of “a temptation to skip the physical exam… You pore over the labs and the studies. You get the consult. You send him to the ICU. But you don’t examine him. That’s not what doctors do anymore, in part because they no longer know how.” Correctly diagnosing a patient requires multiple things to be in place, such as getting the patient’s story, doing the physical exam, collaborating with other providers, and evaluating test results to come to an accurate diagnosis that will guide the treatment plan. The book showcases how this can be challenging but must be done to ensure the proper care is rendered, ultimately saving the patient’s life.

Reading this in a post-pandemic world makes Sanders’ insights even more striking. COVID-19 shifted how medicine was practiced, with telehealth replacing face-to-face interactions and hospital protocols limiting physical exams during this time. Many doctors became even more dependent on technology, reviewing test results remotely rather than engaging in the careful, hands-on examination Sanders champions. While necessary in some cases, this shift also reinforced a growing distance between doctors and patients—one that risks missing vital details only a conversation or physical exam could reveal. Every Patient Tells a Story is a powerful reminder of what medicine risks losing and why reclaiming the human side of diagnosis is more important than ever.

Active Listening

Even though this book focuses on the doctor, nurses at all levels can learn from the lessons Dr. Sanders is speaking about. We are taught in nursing school the importance of active listening and that the patient and family are placed at the center of our care. Active listening during our assessment allows us to focus entirely on the patient's verbal and non-verbal cues. We can build trust and confidence between us and the patient by processing with genuine concern, assessing what they are saying/not saying, and asking clarifying questions to ensure accurate information is documented. Ultimately this will result in better outcomes for all involved in the care. Every patient is entitled to voice their story in person or through telehealth.

Value-Based Care

Have you heard of value-based care? Its early beginnings started in the 1960s when the Center for Medicare and Medicaid (CMS) began looking at the care for the elderly and low-income population and linking value-based programs to payments with better outcomes. In the 1990s, the National Academy of Medicine, formally known as the Institute of Medicine (IOM), in their landmark documents, To Error is Human and Crossing the Quality Chasm, focused on issues in healthcare ultimately noting there needed to be a shift in priorities that ensured patient safety, patient-centered care, and quality measures were obtained. In their book, Redefining Health Care, the term value-based care was first officially coined in 2006 by Michael Porter and Elizabeth Olmsted Teisbery.

5 Key Concepts of Value-Based Care according to CMS

Accountable Care - patient-centered, improved care coordination to reduce fragmentation of care
Care Coordination - coordination of care across various healthcare providers
Integrated Care - provides holistic services to meet the patient's needs
Person-Centered Care - represents care that is centered on the individual's needs, preferences, and values to achieve the desired outcome
Value-Based Care - focuses on quality, affordable care that enhances provider performance and ensures a positive patient experience

(CMS, 2023)

Communication is key in all relationships, especially when helping patients achieve optimum health outcomes. As nurses, we are an integral part of the healthcare team that can assist in telling the patient's story. We have the skills and knowledge to advocate for our patients, so even when our work seems overwhelming, let's not forget who is at the center of our care.

Let us know what you think of the book.

References

Center for Medicaid and Medicare Services. (2023). Value based care. CMS.gov. https://www.cms.gov/priorities/innovation/key-concepts/value-based-care