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Physician Home Dialysis Champions: A Q&A with Dr. Jessica Coleman and Dr. Bijal Patel
Fresenius Kidney Care has launched a new initiative to support physician champions for home dialysis, helping these experts mentor other physicians. The program is part of the company’s goals to provide more patients the option of home therapies that can improve their quality of life and help them achieve better outcomes.
Q: Why did you each want to become a home champion?
Dr. Patel: In my 13 years of being a nephrologist, quality of life has been the first and foremost consideration for my patients. I have always been a big proponent of home dialysis and transplantation. I feel I have had this unofficial role of being a home champion for many years and this opportunity was a natural fit.
Dr. Coleman: Early on in my career I recognized the benefits of home therapies, both with peritoneal dialysis and home hemodialysis. Home dialysis patients not only tend to feel better, but quite frankly, their quality of life is substantially improved as well. In my practice, I had the opportunity to really grow our home program with some great partners, and we now have around 22 percent of our patients on home therapies.
Q: How do you see your role as a home champion and what does it involve?
Dr. Coleman: I have to be someone who leads by example. I’d be a poor advocate if I didn’t have a successful home practice. You have to be approachable, a good listener, and a problem solver when you go into another practice or talk to your peers. You have to put aside your personal biases and listen to the obstacles they are facing. And it’s really not about us as physicians, it’s always about getting patients to the best modality for their needs, whatever that path looks like.
Dr. Patel: Many of our patients have so many obstacles and barriers that they deal with on a regular basis in order to go from being sick to thriving and living well. We want to help all patients get to where they want to be. This really requires being an advocate for every aspect of their care. As a home champion, we want to support other physicians who may not have as much experience helping their patients overcome these barriers. We want all physicians better equipped with the tools, education, language, and process of getting patients to home therapies successfully. By being a mentor and allowing other physicians to ask questions, it will hopefully give them the confidence they need.
Q: What are the biggest barriers you face among some nephrologists?
Dr. Patel: Physicians are very smart and work hard, but we are only as good as what we practice. Unfortunately, a lot of training programs for nephrology in the country accept the path of least resistance which is often seen as in-center treatment. Many of our new medical school graduates simply don’t have much experience with home therapies. Taking care of patients on home is not rocket science, but it does require experience. If you are considered an expert in kidney disease, yet never learned how best to get patients to home therapies, it can be difficult to get past the initial barriers. Our role as a physician home champion is to help physicians obtain the education and experience they need to feel more confident with home dialysis. And it can be very beneficial to have that education come directly from another local physician or colleague.
Dr. Coleman: I found there are a lot of misconceptions among physicians about home therapies and its benefits. And many just didn’t feel very comfortable with prescribing home dialysis. Physicians have an especially hard time accepting there are things they may not know about. I have put together a lot of resources to overcome some of the common concerns when I visit with other practices. I encourage physicians to lean on all the resources available. Fresenius Kidney Care has really stepped up its support in the last few years, with new algorithms for prescribing home and many other support tools for both nurses and nephrologists. This support is critical to growing home therapies.
Q: Are you optimistic about the future of home therapies?
Dr. Patel: Change does take time, but we are definitely making progress. We are seeing many more investments across the industry and from the government into home therapies. People are demanding a high quality of life with lower costs, and home therapies helps fulfill that goal. It requires a lot of education and work to make these changes. I think as more physicians embrace home, it’s moving other physicians along and opening their eyes to the benefits.
Dr. Coleman: I am extremely optimistic. Our patients are now seeing more and more patients experience the benefits of home. They are seeing other patients succeed, and even those who were once reluctant are suddenly excited and wanting to learn more about home. While there is also a push with the government’s Executive Order to encourage home therapies, it’s really a situation where an object already in motion tends to stay in motion. It all starts with the physicians themselves being on board. They have to own that commitment to growing home therapies. When we learn how much patients can benefit, it really behooves us to ensure we offer that choice to all our patients.
About Jessica Coleman, MD
Dr. Jessica Coleman is a nephrologist with Nephrology & Hypertension Medical Associates
based in Beaufort, South Carolina. She received her medical degree from Mercer University School of Medicine in Macon, Georgia, and completed her residency and nephrology fellowship at the University of Kentucky. She also serves as a Physician Home Champion for Fresenius Kidney Care.
About Bijail Patel, MD
Dr. Bijal Patel is a nephrologist with Balboa Nephrology Medical Group based in San Diego, California. Dr. Patel attended medical school at Temple University School of Medicine in Philadelphia, Penn., and completed both his residency and nephrology fellowship at the University of California Irvine. He also serves as a Physician Home Champion for Fresenius Kidney Care.