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Even though doctors generally don’t make “house calls” anymore, Susan Higgins, MD, once found her patient-centered care philosophy required just this approach. When colleagues in Waterbury called her to consult on a patient with cervical cancer who was developmentally disabled, Dr. Higgins drove to Waterbury to visit Jill*. A phone call would not suffice. She performed the consultation at a colleague’s office, and, after a thorough discussion with Jill and her guardian, Dr. Higgins subsequently made all of the arrangements necessary for the patient to receive her radiation and chemotherapy from Yale Medical Group.

Dr. Higgins has been treating gynecological and breast cancers for 16 years and serves as associate professor of therapeutic radiology, and of obstetrics, gynecology and reproductive sciences. She began practicing her patient-centered approach when she interned and served her residency at St. Mary’s Hospital at the University of Rochester. She values the concept of “patients as whole entities, not just a disease.” All of her patients have psychological and social challenges that must be addressed, along with their illnesses and diagnoses, to support them through their treatment.

A safe, supportive patient environment is essential to a positive treatment process for patients diagnosed with breast and gynecological cancers. Dr. Higgins’ team of nurses is well versed in providing patients with a full spectrum of care.

Carol Penta, RN, has worked at Yale-New Haven Hospital for 43 years and with Dr. Higgins for the last decade. “Dr. Higgins has a rapid-fire brain and is three steps ahead of everyone else,” Penta said. She sets up Dr. Higgins’ clinics at the Smilow Cancer Hospital at Yale-New Haven where they see 40 to 50 patients per day. About six years ago, the hospital created doctor and nurse teams. “We love it because it provides continuity of care for the patients,” Penta said.

Penta, Carol Delaney-Ridolfi, RN, and Nannette Thomas, APRN, who work with Dr. Higgins at the Yale-New Haven Shoreline Medical Center, value the standard of care Dr. Higgins practices. “It takes more than one person to create an environment where patients feel safe and are cared for,” said Delaney-Ridolfi. “Dr. Higgins sets the standards and expectations for patient care, and believes it and practices it.”

The nurses are the first people to see a new patient. Careful assessment is vital, and Dr. Higgins relies on her staff to establish the patient’s physiological and emotional status. At this point, some patients have not heard the word “cancer” yet. Dr. Higgins said unfortunately she sees patients “with locally advanced disease with socio-economic challenges that often contribute to late diagnosis.” These difficult diagnoses and treatment plans are where Dr. Higgins’ skills shine. Penta said, “What patients love about her is her warmth and sense of humor when they are anxious.” Delaney-Ridolfi concurred, “She is the finest physician I have ever worked with in my 42 years of nursing.”

Dr. Higgins elaborates on her approach when teaching residents. The technical knowledge she imparts must be expert and articulate, however, she believes she must also help residents develop their own style of communicating with patients. Showing empathy and compassion is the golden rule, but they don’t come readily unless the physician practices them. For example, oncologists often deliver bad news to patients. “If you don’t do it right, the patient will never forgive you,” Dr. Higgins tells her residents. “If you do it right, they’ll never forget you.”

When she has a sense that a biopsy will signal bad news for a patient, Dr. Higgins sets up an appointment to meet in the office, preferring face-to-face interaction to a telephone conversation. This is partly to help the patient get to a place where they understand their diagnosis – and partly to communicate hope and a plan for further management or treatment. “Even when there is bad news, Dr. Higgins breathes life into a room,” Ridolfi said. “With her approachable and friendly manner, a patient’s fear decreases.”

Recently Dr. Higgins treated a patient who delivered a healthy baby, and a gynecological cancer was detected during the delivery. The new mother, Marcia*, struggled with the idea that she may not live to see her child grow up and would have to undergo extensive treatment while caring for her new infant. In situations such as this, Dr. Higgins and her staff rise to the challenge of helping patients work through the fear and uncertainty of illness during surgery and follow-up therapy, as well as informing them of additional aid and resources. As Penta said, “Only God knows outcomes, but if I can make a day easier for these patients, then my day is complete.”

Dr. Higgins’ approach includes taking time to explain short- and long-term side effects so patients can better manage their lives during treatment. “Dr. Higgins is always available,” said Nannette Thomas. “I can always get in contact with her when a patient has a question about symptoms or side effects.”

Both Jill and Marcia are doing fine now, Dr. Higgins said. “I take that information home with me as my reward, and if I am recognized for providing compassionate care, it is the greatest honor I can receive.”