Multiple Sclerosis Care in Diverse Patient Populations: Challenges and Solutions - Episode 7
Jeffrey Dunn, MD, and Regina Berkovich, MD, PhD, highlight the role of a multidisciplinary care team in engaging ethnically diverse and underrepresented patient populations with multiple sclerosis in clinical trials and practice.
Jeffrey Dunn, MD: Let me get real for a minute; if a patient presents to a doctor’s office, the general impression of a nonphysician presenting to a physician is that the physician comes from a very different background. They’ve been educated in the best universities, and their life experience may not be the life experience of the patient. Trust, as I’m sure you agree, is critical toward clinical trial participation and talking to people about potential experiments. If the patient ultimately thinks—they may not say it out loud—but if they think, “Doctor, your experience is not my experience, and even though you’re advocating for science, you don’t get me.” How can we break through that wall, as physicians and practitioners, to earn their trust? My sense, as you can imagine, from my question is that a huge part of being able to present to people the opportunities they have is based on trust; that we get them, we stand for them, we know where they’re at, and we know what their lives are like, even though our lives may be somewhat different. How do you break through?
Regina Berkovich, MD, PhD: The experience is going to be different in different settings, because I look back at my experience with my current clinical trial participants and I realize I have a high percentage of Hispanic and African American patients who are part of the different clinical trials we do. I must say that I’ve known these people for a few years, so those are not the people who just came to my office. I guess you earn trust first, then you can effectively suggest the clinical trial and still be trusted, because you’ve earned that trust in your previous years working with this patient.
Jeffrey Dunn, MD: Agreed. So, trust can be earned the more time you spend with the patient, but a busy practitioner such as yourself and our colleagues nationally—time is precious. You don’t have a lot of time. You can’t give an hour to a patient in consultation. What would be the role of your ancillary team, nurse practitioners, nurses, other therapists, for example, who may be in the office, in working with your patient? Can they spend time for the sake of education, and do you employ that strategy to help improve education and awareness on the part of the patient?
Regina Berkovich, MD, PhD: It’s very important to have a supportive and professional team, so sometimes it is not so much the length of time we spend earning that trust. It could be intensity. It could be a relatively brief period, but here we treated multiple sclerosis exacerbation, here we went with one option, another option, and patient gets this understanding that we are after the best outcome for them.
Transcript Edited for Clarity