Good things and some announcement effects as always in this plan cancer 3 unveiled by the President of the Republic last February 4, plan that I will not decrypt in detail here since you have probably read and heard a lot about it since last week. I preferred to turn to an extent ignored which nevertheless could help change things significantly for patients!
Here are just some of the flagship measures in bulk largely relayed by the media: reimbursement of additional examinations (ultrasound) during screening for breast cancer, generalization of screening for cervical cancer, doubling the management of hair prostheses (not breast prostheses, why?), removal of the remaining burden for post mastectomy reconstruction, ease of access to supportive care, increased inclusion of eligible patients in therapeutic trials, strengthening of the fight against tobacco and the already famous right to be forgotten with the planned revision of the AERAS convention. Measures expected by all to follow closely!
What we may have been less talked about is the chapter "Enabling everyone to be an actor in their care, p.68 and following, and more particularly action 7-15:" to support experiences of participation of volunteer resource-patients in caring for people with cancer and in the training of health professionals and evaluate their contributions and conditions for success (recruitment methods, training of volunteers ...) ". This was one of the proposals I made during my audition by the team of Professor Jean Paul Vernant who had been very attentive.
In other chronic conditions such as inflammatory bowel disease, some hospitals already have two-headed bipolar patient / health professional education programs that work very well. It is therefore easy to imagine transposing what already works for IBD to a disease such as cancer.
But this measure is more ambitious since these patient resources could go as far as training professionals! And that was not won! This is already the case in some countries such as Canada (Quebec) where the patient's expertise is recognized and where some of them participate in the initial training of doctors. So let's dream a little and imagine patients in front of our medical students teaching how to announce cancer, the importance of listening, life with treatments, management of side effects, the after and let's go further (let's be crazy), patients who would explain their expertise of the disease, the doctor / patient partnership, the importance of negotiation, the shared decision!
To be quite accurate, I asked much more (of course), in particular, remuneration of these patients that I had called "experts" and not "resources", term probably chosen to spare some susceptibilities. This remuneration would have been a guarantee of sustainability and largely offset by a decrease in the costs related to non-compliance or the numerous emergency room consultations, for example.
This is also what the authors of this article " the patient trainer, theoretical and practical development of a new health profession" published on the site of the IRDEF (Interdisciplinary laboratory of research in didactics, education and training): " Approaching this model (editor's note: that of firefighters) to patient trainers, a small part of paid trainer patients among a set of volunteers or volunteers organized according to the availability and conditions of service of mission of general interest could thus participate to decrease the costs generated by the problems of compliance and by the other problems of additional costs, both financial orders, quality of life deficit, and human resources. Would not that be what health systems are becoming more and more constrained?
Second downside: if we read well, we limit ourselves to support experiments and to evaluate them without extending on the concrete implementation. We have the right to ask ourselves: Who will get into the experience? How and with what support? Who will evaluate? According to what criteria?
Moreover, if we look more closely, we find many vague verbs concerning the means used for the measures of this plan are transformed into reality: identify, study, reflect, experiment, recommend, facilitate, promote, evaluate. Rather than set up, produce, develop, guarantee.
I read a lot about the internet lately about him. Traditional media that praise his ambition and voices from including more skeptical Internet users. Obviously the previous plans are struggling to get established in a generalized way and some measures have even remained at the stage of wishful thinking. Of course we are still waiting for more: what about primary prevention besides tobacco, clinical trials in pediatric cancers, the place of psychologists in the care path, the rest of the burden and so on! Yes, yes and yes. But other countries are not willing to put 1.5 billion euros on the table to improve the care of their congeners with cancer.
The criticism is easy and this plan is indeed criticize and incomplete but not at all goes I prefer the yes ... yes but! Yes to this plan even if it is perfectible but especially, let's be vigilant! Vigilant that the measures lead to concrete actions, and of course that these actions are widespread quickly throughout the territory. This is the commitment to be made by the INCa in charge of its implementation.
Rather than make a ticket to load (I would have found material :)), I prefer to be optimistic and hope that things move quickly for all of us because we do not have time to wait!
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