BIDMC’s Schwartz Center Rounds

Sick, scared, and tired of waiting to see his physician, the patient stormed out of the waiting room. A staff member knew he was desperately ill and ran after him, begging him not to leave. After talking for 20 minutes, the patient returned to the office. Later the staff member learned she had saved his life.

A clinician shared this experience during a monthly Schwartz Center Rounds at BIDMC, where clinicians and front line staff discuss tough patient care issues: When do you tell a terminally ill patient it’s time to stop treatment? How do you handle a patient wanting to switch providers?

“It’s a ‘safe place’ for providers to share feelings — for example, about a patient they felt close to whose death deeply affected them,” says Program Coordinator Nancy Julian, ethics and palliative care.

The rounds were established in 1997 by the Kenneth B. Schwartz Center, named for a well-known health care attorney who battled lung cancer and sought to promote a compassionate health care system. Rounds have taken place at nearly 50 U.S. medical institutions — including BIDMC, which held its first rounds last year with a grant from the Schwartz Center and support from the Rabb Family Foundations.

BIDMC Trustee Nancy Cahners and Ethics Support Service Director Lachlan Forrow, M.D., helped bring the rounds to BIDMC. Rounds co-director Anna Berkenblit, M.D., hematology/oncology, explains, “BIDMC has always prided itself on the ‘human’ aspect of medicine. The Schwartz Center rounds are another manifestation of that.”

Clinicians present a patient’s clinical history, followed by audience questions and feedback. Senior Clinical Social Worker Frank McCaffrey, L.I.C.S.W., hematology/oncology, facilitates.

“We’ve been fortunate to have many panelists be quite open about their emotional response to their work, and to have very interactive, yet respectful, audience participation,” he notes.

During one session, front line staff discussed patients who confide in them, but not in their physicians. “One patient expressed concern that she would not be treated the same since there were no other minority patients in the waiting room,” said Brenda “Bree” Saucer, phlebotomist, hematology/oncology. As a minority staffer, Saucer could reassure her.

Rounds co-director Leonor Fernandez, M.D., general medicine, reflects, “We need to keep our approach personal and compassionate. Our lives — and our patients’ — gain meaning when we work in such a fashion.”

“Patients feel better knowing there is someone they can relate to,” said HCA Practice Assistant Davita Collins (l, with Saucer and McCaffrey) at the rounds.

Published monthly for the people of Beth Israel Deaconess Medical Center to build community, communicate direction, foster pride and recognize accomplishments.

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