Patients’ guide to Slow Medicine

Receive better medical care by self-advocating: Ask your doctor to try the Slow Medicine approach

Slow Medicine

Slow Medicine, a term coined by Dr. Dennis McCullough of Dartmouth Medical School, describes a cultural shift toward quality of life and care for older people. Dr. McCullough’s book, My Mother, Your Mother talks about the necessity in "slowing down" the decision-making process when it comes to figuring out what specific methods of care are best for our aging loved ones or ourselves.

These answers are not "cures" to be found in medical texts, rather, they are part of a larger movement toward quality over the "quick fix," helping to slow things down that are moving too fast – something that particularly affects older people right now. Rather than treating the ailment or disease, Slow Medicine focuses on patients’ quality of life.

Like so many other cultural changes, Slow Medicine is starting from the "ground up." Dr. McCullough has found that lecturing doctors on what to do during continuing education meetings or through articles has largely been ineffective: Doctors care much more about what their patients have to say, because those are the people who keep their practices in operation.

Physicians will respond to the evolving needs and preferences of their patients, if the patients make these needs and preferences clear. It starts one person at a time.

If you want to receive the Slow Medicine approach from your physician and make a difference in your own situation, you will need to start by advocating for yourself. If you feel unsure or would feel better with extra support, bring a friend along who understands your preferences and can help you to explain them.

Because doctors are typically required to focus on particular organ systems – or whatever they have been trained to specialize in – they have a harder time seeing the larger issues that have to do with patients’ living circumstances, social support networks (or lack thereof), and how they’re meant to move around/mobility issues. Many difficult day-to-day living demands are placed on an older person without their doctor even being aware of them.

For example, a patient needs some blood thinning after a stroke; there are two medications available: Aspirin is one, and the other is Coumadin. Coumadin is somewhat more effective, but it requires an older person to have blood tests drawn quite frequently. The implications for the family and the patient are sometimes not fully appreciated – frequent appointments can be a tremendous commitment and time demand, not to mention exhausting and anxiety-producing. Aspirin might be slightly less effective, but it could be the preferable choice because it gives the family "more of their life" back in the long run.

"Family" isn’t restricted to the biological family – many older people are choosing to bring their friends instead of family members for various personal reasons. What counts is to find your "circle of concern," which should include the people who really know you best. Those are the people you want there with you at your doctor’s visit.