Article - March 13, 2008 - NephrOnline

World Kidney Day: The patient-physician relationship

By Judy Weintraub

My nephrologist is not only my physician but also my mentor, protector, advocate, supporter, cheerleader, and trusted friend. And that didn’t happen overnight.

I have observed and experienced a lot in my 33 years of dialysis, and long ago decided to stick with Dr. Frank Strauss. After my second unfortunate attempt at transplantation, he encouraged me to switch from in-center hemodialysis to CAPD, a modality I did successfully for an incredible 12 1/2 years. When my third kidney transplant was heading downhill after three harrowing months, I had to console him as he stood at my bedside. “The kidney is going, but we are moving forward,” I told him. Dr. Strauss staunchly supported me in my quest to find a facility that would begin a home nocturnal hemodialysis program, which I am now grateful to be doing for more than five years. He was part of my 40th birthday celebration, attended a final performance during my foray into theatre, and last year, danced at my wedding.

On March 31, 2008, after 35+ years of practice, Dr. Strauss will retire from the field of nephrology. During that time, he has conducted himself with dignity, professionalism, and grace. His intelligence and wisdom have served his patients well. He has earned the respect of his patients, colleagues, and all those he greets by name daily in the hospital. I have learned a lot from this man and will continue to “roll up my sleeves and figure things out” as situations arise.

This crossroads in my life gives me the opportunity to reflect on what I need from a physician and what I need from the renal community at this stage in my life. I need a physician who is intelligent, insightful and well versed in the latest the field has to offer. I need someone who knows how to listen and can partner with me in the development and implementation of the best treatment plan possible. Scratch that––after all these years, I know I’m the one that implements my renal replacement therapy as well as exercise and nutritional programs. That’s the only way I’ve been able to do this for the long haul.

And what do I need from the renal community? In a recent article published in Nephrology News & Issues, it was stated that all home hemodialysis patients in the United States are being seen by a mere 5% of practicing nephrologists. Ouch. The superior outcomes and higher quality of life for those doing home therapies are well documented. We need to boost the level of awareness and education in our renal physician community––those just starting out and those who have been around for a few decades. They are the gatekeepers and truly have the ability to partner with the growing number of individuals willing to commit to this option for the considerable long and short-term payoff. I believe that with the right level of expectation, we can look forward to one day seeing a full 10% of the growing dialysis population achieving a quality of life they didn’t dream possible.

Full story