Treatment Decision Factors for Clinicians
Prioritize treatment decisions for unsheltered patients based on the following:
- Triage emergent and grave disability situations vs. urgent needs vs. chronic needs.
- Improve or maintain a patient’s personal safety in their environment.
- Reduce pain and suffering.
- Reduce risky or harmful behaviors.
- Improve the patient’s overall health.
- Address concerns from the mental, physical, substance use and trauma perspectives.
- Tailor treatment regimen to a patient’s ability, wishes, lifestyle, practicality and level of tolerance and adherence.
- Follow a respectful process of negotiation, persuasion and collaborative decision-making.
This decision-making framework stipulates that the clinician should adapt the treatment plan and document the recommendation based upon the above priorities for decision making. For example:
- If a patient cannot come into the clinic for a blood test, could a medication be prescribed that does not require a blood test, even if it is not the typical first-line treatment option?
- When a patient cannot afford the ideal medication, can an alternative be prescribed or the care plan modified in some other way to reach a similar outcome?