Suzana Makowski, MD

I am a palliative medicine physician working at UMass, interested in humanism in medicine, integrative medicine, interventional pain management, cultural competency, complexity science, quality. Having grown up in Brazil, England, the Philippines, Peru, Bahrain, Hong Kong, Austria and the US, I have an interest in international palliative care.

Homepage: http://www.loisgreenlearningcommunity.org


Posts by Suzana Makowski, MD

Getting ready for 2012 AAHPM bookclub: help us pick next year’s book

Medical Humanities has played an important role in my personal development as a physician and palliative medicine doctor. Reading stories, novels, poetry, listening to music, looking at art and movies and plays have helped teach me

  • how to face suffering,
  • how to sit with it,
  • how to be curious about and wonder what will emerge if I stay long enough.

Two years ago, the humanities and spirituality SIG at AAHPM launched a book club – with Drew Dipin Faust’s The Republic of Suffering: Death and the American Civil War. This year, we followed with A. Verghese’s first novel, Cutting for Stone.

At the Academy meeting in Vancouver, we solicited proposals for next year’s book from people who attended the bookclub discussion. Instead of keeping the voting and selection to an insular group, we tapping into the emerging culture of “open access” and social media by opening the voting to the community at large – http://www.surveymonkey.com/s/2012_BookClub

To allow everyone time to read the book, we are selecting it early this year. The deadline for voting is coming up quickly. Please vote for your top 3 choices! While we will select the most voted for book for the Annual Assembly, the next most popular books will serve as topics for discussion for each season of the year.

Thanks for participating!

Suzana Makowski – Co-Chair: Humanities and Spirituality SIG

Quality and competency: Invisible members of the palliative care team, the Medical Interpreter

We spend a lot of time speaking of physician, nursing, social work, pharmacist expertise in palliative care. We often see and support formal training for volunteers. (www.volunteertrainingonline.com/hospice; www.hospicevolunteertraining.webs.com) We teach the importance of culturally competent care and use of interpreter services to enhance communication with patients and families of other cultures and with limited English. Studies have shown the miscommunication that occurs when interpreters are not used in medical encounters.

At the European Association of Communication in Healthcare (EACH) conference in Verona Italy the opening keynote speaker, Phyllis Butow, a psychologist and professor of psycho-oncology and medical communication, presented research that caused me pause and concern. Her research, conducted in Australia, demonstrated that our assumptions about accuracy of language transmitted to patients/families when interpreters are used may be flawed – especially when interpreters lack training in giving bad news, end-of-life care, etc.

Her interviews with interpreters also revealed that professional interviewers define their role as cultural (as well as language) interpreters. In doing so, “cancer” sometimes was described as “mass” or “tumor” according to her presentation. Interpreters expressed similar cultural biases and fear of giving bad news as many other healthcare professionals.

  • How often does this happen in North America, as it seems to in Australia?
  • How much training do medical interpreters in the US, Canada, and other countries receive in delivering bad news, end-of-life care, death and dying?

Mandating the presence of a medical interpreter may not be enough when it comes to improving cross-cultural and inter-language communication in palliative care scenarios: we need to include medical interpreters in our definition of interdisciplinary teams, provide them training (not just teach physicians and advance practice nurses how to work with interpreters) in giving bad news.