The Power of Person Centered Care with Cynthia Overton
In this episode, we sit down with author and advocate Cynthia Overton to discuss her new book, The Clear Cane Chronicles, which explores what person-centered care really looks like in practice. Cynthia explains the evolution of models of care from traditional to patient-centered to person-centered and how the last one looks beyond the medical condition to the whole individual, considering lifestyle, relationships, and beliefs. She shares her personal journey of surviving spinal cord surgery in her twenties and how her recovery shaped her passion for improving healthcare systems to be more compassionate, collaborative, and responsive.
Cynthia opens up about the critical role her family played in her healing process and the challenges she faced navigating the insurance system when coverage for her life-saving surgery was initially denied. Drawing on established frameworks such as the Picker Principles and the National Advisory Board’s six principles, she outlines how providers and patients can work together to achieve better outcomes. She also shares how modern healthcare organizations, such as One Medical, exemplify person-centered care through accessibility, convenience, and genuine collaboration between doctors and patients.
Listeners will learn how Cynthia’s experiences and research have informed her call for systemic change, empowering patients to take an active role in their own care while urging providers and payers to adopt practices rooted in empathy, dignity, and partnership. Her book, The Clear Cane Chronicles, is available on Amazon, and Cynthia will soon share excerpts and practical insights for patients on her website and Instagram.
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TRANSCRIPT
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Host
Cynthia Overton, thank you so much for being on the podcast.
Cynthia Overton
Thanks for having me, John.
Host
You recently wrote a book, The Clear Cane Chronicles, and for people who aren't familiar with it, I think we should start there. Tell us a little bit more about The Clear Cane Chronicles, where the idea for the book came from, what it goes over, and why you wrote it now.
Cynthia Overton
Mm-hmm.
Cynthia Overton
Okay, excellent question. Great place to start. Clear Cane Chronicles is a book I recently released. It's a book really that focuses on person-centered care. And it's really designed to make person-centered care simple, relatable, easy to implement. The book shows what person-centered care looks like in action. I use all these stories. I use actually...
very established frameworks to talk about person-centered care. And then, you know, everything is really supported by research. And I wrote it specifically for patients, providers, or like doctors and other healthcare professionals, and payers, so insurance companies, because, you know, those three audiences are just, of course, so essential to the types of care that we receive as patients and how care is delivered.
Host
A lot of people listening to this podcast are advocates and they're familiar in the medical space, but we do get people who come in a little bit more cold than that. Why don't we back up and explain what person centered care is and why it's not the norm in every situation.
Cynthia Overton
Sure. Okay.
Cynthia Overton
Okay, okay, that's a perfect place to really kind of dive into. All so I always answer this question by bringing it back to kind of like what most of us have experienced and that's traditional care, right? Traditional care is provider driven, know, the doctor diagnoses you, tells you what the plan is and you follow it. That's the kind of care that I grew up with. Then we think about patient centered care.
Host
Mm-hmm.
Cynthia Overton
That shifts things just a bit. And patient-centered care is fantastic. It's much more collaborative than traditional care. It respects your preferences. It involves, you know, patients and decisions about their health. Fantastic. But person-centered care is really where the magic happens. It looks as you as like the whole person within the context of your entire life. You know, it takes into account your personal.
goals, your relationships, your environments, even your belief system. It's care that kind of like extends out of the doctor's office and makes space for your lifestyle, bringing that to the table. And so it's a thing of where you're an expert in your life, what you need. The doctors, of course, and the nurses, they're experts when it comes to the medical part.
And so the idea is really for people and medical professionals to really work together to provide the best care possible that's personalized. And here's how I really, really like to describe it. I describe person-centered care, really all three models of care, I bring it back to television. know, we've all seen, many of us I should say, have seen how television has evolved where...
We had the old school TV, network TV. That's kind of how I think about traditional care. know, one size fits all. You've only got a few channels to choose from. Patient-centered care is kind of like cable. You know, you've got more choices, right? But you're still, you know, on somebody else's schedule. You're still, you know, bound by the system. Person-centered care, that's kind of like streaming. You know, it's personalized, on demand, it's responsive.
You know, the system knows you, supports your choices. And, you know, that's kind of where every industry is, has evolved to or is evolving to, you know, how we catch a ride, how we shop, you know, where you, how we even think about, you know, people coming into our homes to do these household tasks. That's just kind of like how industry has gone. And so we're really looking to see healthcare.
Cynthia Overton
follow suit. So that's kind how I think about person-centered care.
Host
And why did you get so passionate about this personally and what made you do so much research and so much work to actually put a book together?
Cynthia Overton
Okay, so a lot of this is based on personal experience and I was very fortunate about, gosh, back in 1997, I was like 26 at the time, I had spinal cord surgery to remove an arteriovenous malformation from C6, C7 of my spinal cord. Now, back then medicine had not evolved to where it is today. So that was a
very dangerous, a very risky procedure that a lot of doctors did not want to do. Now, I was very fortunate in terms of how I was diagnosed. You know, I got the tests that I needed. I had great care during the diagnostic process. The issue is, is when they realized what was going on with me, there was really not a doctor
or at least within the state where I was living that had the level of expertise that we were looking for to do this surgery. Because the spinal cord, controls, of course, how you walk, but it also controls how you regulate temperature. It controls how you perceive pain, your bowel and bladder function. I I like to describe the spinal cord, I think, about Beyonce.
Beyonce was a body part, she would be a spinal cord, because the reach is just like huge, right? So we really want it. When I say we, I mean me and my family. family support is so critical to person-centered care. We're really looking for a doctor who was able to do this surgery with some background in it. We ended up going all the way to New York.
Host
Hahaha.
Cynthia Overton
to have the surgery done by an incredible world renowned surgeon named Fred Epstein. And it's so funny, John, because when we first went to meet him, the nameplate on his office, and he insisted on having a pre-op meeting with us, nameplate on his door just said Fred.
Right? mean, no doctor, this is a world renowned surgeon about to dig in my spinal cord. He's going around, you know, calling himself Fred. I mean, like not even Mr. Rogers went by just Fred, right? You know, kind of like the guy who fixes your car, So anyway, he was just so compassionate and sympathetic or empathetic. And the fact that he really wanted to meet with us, to understand us as just people and a family.
Host
I think this friend.
Cynthia Overton (07:26.3)
And the conversation, this happened 28 years ago, but I still remember the conversation like it was yesterday. And in many ways, I just feel so fortunate that we were able to get the type of care that I needed. Now, it wasn't easy. The hardest thing that we had to deal with was the insurance company, right? Because they did not want to cover an out of network
doctor to do the operation. But it was just interesting because had I gone with one of their in-network doctors, there's a good chance that I would not have had a positive outcome. And so it really, for me, demonstrated the importance of engaging family and advocacy because, quite frankly,
had I been born to a different family that did not know how to really speak up on my behalf and be persistent and even look for alternative avenues. I mean, my mother, we were denied over and over again by the insurance company. And we talked to anybody who had listened to us to plead with them to have this expert do the surgery. And it was the
my parents decided that they were going to just have to take out a loan against the house. And it was the morning that my mother was going to go to the bank to fill out the paperwork that the insurance company called to say that they would cover the operation. you know, financially it would have been a hardship, but I was very fortunate that we had options.
I was in the hospital for a total of seven weeks. In fact, I wasn't just in one hospital, wasn't in just two hospitals, I was in three hospitals over seven weeks. And it's just really interesting. And I talk about this in the book in terms of recognizing my experiences and being able to track them back to person-centered care and how many of those experiences really aligned with person-centered care.
Cynthia Overton
But there are some that really fell short. And I talk all about that in the book. And I draw on two frameworks for person-centered care. One is called the Picker Principles. And those principles are based on research that the Picker Institute, which is based in the UK, did. And I also draw on the National Advisory Boards.
six principles and their principles really focus on people with disabilities as well as aging or older populations. In terms of kind of like with my prognosis, we did not really know what I was dealing with until the doctor, I had the operation, the MRI found a lesion.
And we were very fortunate there was not a cancerous tumor. But after the operation, I was paralyzed. I was paralyzed from the waist down. And I had to go through a very long process to get up and walking again. But I'm just forever grateful in terms of I had access to the health care that I needed to get the best outcome possible.
Host
How long did it take you and what was that recovery like to go from paralyzed to walking again?
Cynthia Overton
Yeah, that's a really great question. So hospital one, I was in for one week. Hospital two was in New York. That's where I had the surgery. That was two weeks. I was in inpatient hospital for another four weeks. And then when I was discharged, you know, I was walking, like holding on to things for dear life with somebody else holding on to my,
waste with one of those gate belts. But in terms of independently walking, I was walking within a year. I'll tell you the motivating factor that got me up is that I was taking classes at the time, working on my teaching certificate. And it is so interesting because
I, my mother made me register for classes, like from the hospital bed. She was like, no, you're going to do this. And I was like, well, wait a minute. No. And then, you know, I called to register the guy was like, Oh, you, was back in the olden days. You got to come in and register. And I just couldn't stop talking. I told him for some reason I was in the hospital. He registered me on the spot. So, uh, had to enroll and we took a trip, Jen, to the children's science museum. And it was, and they, they,
Instructor told us about this trip. said, she said it was a two story museum with no elevator. And I said, excuse me, how did children get to the second floor who don't walk? And the teacher said, they carry the children up the stairs. And the thought of being carried up the stairs, I just could not implement. And so I like worked extra hard.
in physical therapy. And by the time we had the trip to the Children's Museum, I was still in a wheelchair, using a wheelchair to get around, but I had enough strength to get up and kind of like use the banister to, exactly. Exactly. It was kind of like rock climbing, but just with stairs.
Host
Climb the stairs.
scale the mountains.
Host
You're amazing. What an amazing story. So talk to me more about some of these principles. You know, I will admit I've heard the term person centered care. I've heard the term patient centered care more. And I think the provide like you're right. The provider driven care is what most of us are used to where you go in, you have 10 minutes, the doctor diagnoses you. They give you a set of instructions on what to take, what
Cynthia Overton
Mm-hmm.
Host
to do what not to do, and that's kind of the end of it. But I am finding a little bit of confusion between patient-centered and person-centered, and maybe you can spend a little more time separating those two, maybe even by kind of citing some of the Picker or the National Advisory Board's principles as examples.
Cynthia Overton
huh.
Cynthia Overton
Yeah. So, I mean, one of the principles, and I don't have them all memorized, but I can tell you the spirit of the principles, but yeah, sure, sure. So one of the principles, you know, fast access to reliable healthcare. You know, a lot of people don't have that. And I mean, in the way things are kind of going, I know that healthcare is a very big issue. And it's something that we really struggle with. Being treated with dignity, empathy, respect.
Host
Yeah, yeah, of course.
Cynthia Overton
That's also the, you know, the spirit behind one of the principles, which can be very chant. Here's the thing. Doctors go into medicine to help people. go into solve problems. They go into medicine to make people's lives better. Right. They get into medicine and find that they're kind of like bound by all of these administrative restrictions.
that put a lot of pressure on them when it comes to the amount of time that they're able to spend with patients versus the administrative tasks that they have to deal with, namely, I'll say working with insurance companies and just doing all of this paperwork. And so I say all that to say that when we think about person-centered care, it's a reminder for us to really think about why we're here in the first place.
And it's almost kind of like a call to the hospital administrators to say, hey, we really need these physicians and nurses to be in a relationship with us, not the paperwork, right? Another important thing when it comes to person-centered care and the Picker Principles is family support.
really, really important to be able to engage families as well as other loved ones. And it's just so interesting because when you have the family support there, they serve a few roles. First of all, they're able to kind of like fill in the gaps, especially when a patient might be a little bit too shy or may feel as though they don't want to bother.
the provider with the details, a family member will come and say, well, wait a minute, you know that you were having headaches or you you get dizzy sometimes or whatever. And then also, at least with my situation, the providers in a sense, and my parents were always around when I was going through my ordeal, almost deputized my parents. My father would come after work, and this was in the rehab hospital.
Cynthia Overton
tie that gate belt around my waist, brace me up and walk with me in the hallways for practice. And he was able to do that because the staff there were just so amazing in terms of training and helping my family do what they needed to do to support me. That really helped move my progress along. It also meant that
By the time the holidays came around, because I was in the first, no, I was in the second hospital over Thanksgiving, the third hospital over Christmas and New Year's. But by the time the holidays came around, they felt so comfortable with my family being there and understanding what I needed that they let me out for like three hours to have dinner.
with them during the holidays. And so for me, was just a very important moment for me. And so the principals, when we're thinking about person-centered care, just they do an amazing job of providing that North Star that we all know is the right thing to do, but we've got to really think about implementing
these principles throughout our practices. You know, I think that it's such an important question that you ask in terms of the difference between patient-centered care and person-centered care. Person-centered care really considers the context of one's whole life, whereas patient-centered care is amazing, it's great.
but it's really confined more so to the walls of a doctor's office. And I'll tell you kind of like who, and I'm not saying that this is patient centered care, but I'll tell you who understands the concept, in my opinion, the pharmaceutical industry. You watching these television commercials, you see people blowing bubbles with their grandkids or going on hikes or.
Cynthia Overton
you know, soaking in the bathtub on a beach, which I didn't even know was the case until I saw this pharmaceutical commercial. OK, that's not person centered care. That's marketing. But they've tapped into that vision of what you have for your life. And that's really what person centered care is all about. is what is your vision? What is your goals? What are your goals? What are the relationships, the environments? What are all of the because we know
Host
Yeah.
Cynthia Overton
all of these social factors impact our care. And at the end of the day, patients want healthcare options that work for them, right? When we think about providers, providers are experts when it comes to the evidence and all of the things that will make us better from a clinical standpoint.
they can tell us what to do, but how many times, I mean, how many people do we know, okay, myself included, have been told to do something by the doctor, but if it doesn't fit my lifestyle, you know, they've got all the power when I'm in the room. I've got the power when I'm out living my life. And so it's a matter of really trying to understand the person so you can develop options that meet their needs, their needs.
I'll give you an example. In fact, I'll give you two examples. My primary care physician who I'm happy for her because she made a great life change and she's moving, but that means that she's no longer my doctor. In fact, when I found out she's moving to Texas, I was like, wow, that's going to be a long way to have to go to see my primary care physician. It took me a minute to realize she's no longer going to be my physician.
One of the reasons that I really liked her is that she listened to me and everything was a negotiation without it feeling like being in a negotiation. Like, Cynthia, I need you to exercise 30 minutes a day. I don't want to exercise 30 minutes a day. Well, what do you like to do? Well, I actually have this app that I like is called, you know, Supernatural. a virtual workout. I really enjoyed doing that. And I do it on high intensity. And then she looked it up.
And she read about it and she says, that looks good. I just need you to do it 30 minutes a day. So my point is we were able to kind of think about what it is that I like to do and come to, you know, common ground. But another example, and I promise you, I'm not paid by one medical. just happen to love one medical because for me, they really kind of get.
Cynthia Overton
person-centered care. don't know if this was their intention, but in my opinion, they get it. So let me kind of just give you a background on it. One Medical is a service that you can subscribe to where you have your primary care physicians. use lots of technology, making it very easy for you to schedule an appointment, cancel an appointment if you need to. All of your medical records are right there. It really empowers the patient to access
care the way that they need it. So there is one day, excuse me, I was headed out of town. I had a skin abscess, which I understand that if, you know, they burst, they can essentially kind of get into your bloodstream and it is not good. Here's the issue, John. I was getting on a plane the next day. So I scheduled a virtual telehealth appointment the night before to talk to the doctor.
I figured, she'll just give me some antibiotics and I'll get on the plane and go. I scheduled this telehealth appointment. I explained what's going on. She says to me, you got to be seen for that. I can't do that virtually. And I was like, well, I have a plane to catch. I don't know what I'm going to do. And so she went on her computer, found a
doctor's office, a one medical office that was literally on the way to the airport. She called in a prescription for antibiotics for me. I went across the street. mean, kind of across the street. I drove there. I probably could have walked, but I drove. Don't judge me. I drew, went and picked up the prescription, came back home, picked up my bag, hopped in an Uber, went to the appointment, which was a literally one block.
off of the path to get to the airport, got examined, the doctor examined to see where it was in terms of the stage or whatever, determined that it was safe for me to fly and made an appointment for when I got back to town and I was able to then hop in a car service, get to the airport and make my flight. Now, can you think of anything better than that when it comes to care?
Host
No, that seems like a white glove, you know, that ushered you through the whole process. That's pretty amazing.
Cynthia Overton
Yeah. Yeah. Yeah. And I, and honestly, I have used that service in, you know, one time I had to, needed to get some blood work done. had an hour to kill before I checked into a hotel. this was in LA. I live on the East coast now. Just went to the site, got my blood work done, easy breezy. I've had medical emergencies,
One in New York, one in Chicago, was able to make an appointment, went right in. And when I say medical emergencies, I mean that involve broken bones, little baby bones, but still, but was able to seen and get the next step and direction that I needed. So I'm not saying that they're urgent care. They're not urgent care, but they're a place to go so you can kind of understand what your next step is.
Host
Wow. Yeah.
Host
Yeah, I think that helps. Using those examples really does kind of paint the picture of the difference between patient and person-centered care for me. mean, there's, I think you said the word holistic early on. There is a more holistic collaborative approach to the person-centered care than just being patient driven. Who is the book that you've wrote? Who's it really targeted for? Who's meant to read it and what are they meant to get from it?
Cynthia Overton
Yeah, so three primary audiences, but it's really for anybody. First of all, it's for anybody who wants to be entertained. mean, it's really intended to be very conversational as well as educational. So three primary audiences. We've got your patients. First of all, when I was a patient, John, I did not know what it was like to be in a hospital. I didn't know what...
Like when I was told that I needed to go to the hospital, I didn't even know what it's going to be like checking in. Like I'd only seen, you know, emergency room admissions and, know, in terms of people coming in on girdies or whatever. So I didn't know what that was like. I didn't know what it was like to get an MRI. I didn't know what it was like to, you know, be in a hospital room, you know, with a patient.
that was going through another medical emergency. I mean, there were just so many things about hospital living I had no idea about. So I want patients to have a picture of what it's like and what to expect as they kind of navigate the healthcare system. And then there was also the whole new experience of transitioning into disability. You know, I had zero mobility issues before
Host
Yeah.
Cynthia Overton
I realized what was going on. Just one day my foot stopped working. I developed foot drop. And from there, that's what kind of led us to understand that we had a spinal cord situation going on. But after the surgery, I woke up paralyzed. I mean, from the waist down. And here's the thing, John, I didn't know I had a disability.
until my doctor back in Michigan offered me paperwork for disability parking. And even then I was like, who's this for? And I was in a wheelchair at the time. So, you know, I want folks to understand what it's like to transition or at least what it was like for me to transition into disability. And then also I want people to know that, you know, it's possible to build a new life. And I...
I gotta be honest. Like, I think my life is a lot better now having had all the experiences that I've had in life, which includes the spinal cord surgery and being paralyzed and all that. I think my life turned out, you know, better than it would have otherwise. So I really want patients to understand that healthcare
is a team sport and you've got to be an active player, you can't just let healthcare happen to you. So that's what I want the first audience to know, patients. Second audience is providers. And I think that it's just, like I said before, just really challenging for providers because there are so many things that are happening behind the scenes.
that we as patients don't necessarily see, understand, or appreciate. That's not to say that we don't deserve top notch care because we do, but there's a whole big context in terms of the system that we're operating in. So for providers, I really want doctors and nurses and other healthcare professionals to understand that
Host
Mm-hmm.
Cynthia Overton
everything that they do makes a difference in our lives. mean, Emma, that second hospital, I still remember the nurse's assistants who just treated me with such dignity and respect. mean, think about, you know, I'm a woman who has every personal care need that has to be done by somebody else.
And in that particular hospital, you can either get a man or a woman to come and take care of you. Now you could refuse, but who knows how long it would take for somebody else to come. And I mean, they just, the level of professionalism by the second or third day, I was just like, whatever. But healthcare workers have really, and then also my physician.
Host
Right.
Cynthia Overton
It's so interesting Dr. Epstein has passed away. This is somebody who I only met during that one period in my life, which was 28 years ago. And here I am talking about him 28 years later. I wrote quite a bit about him in the book. And in fact, when I had my launch party, his widow
Host
Yeah.
Cynthia Overton
and his son were kind enough to attend. And his son, who is now a physician, actually made remarks about his father for me. So I thought that was really nice. But bottom line is that I want providers to understand that the care that they deliver really has a significant impact on the lives of the patients that they went into medicine to serve. We appreciate them. And I also want them to really extend us grace and patience.
Host
Or well.
Cynthia Overton
as we try to express what it is that we need, because the things that come out of a patient's mouth, they matter and they're important. They're important to recovery. And so my hope is that providers will take our preferences, our needs, our environments, our beliefs into account and with us co-develop care plans that we'll actually act on.
And then there are the payers. That's the third audience. This is the insurance companies, the insurance industry. You know, we need our health insurance. We need that coverage. As I said before, it was a very, very bumpy road starting off, but they, my insurance company ended up paying for the surgery. We know that the insurance industry now is
really, really being challenged when it comes to trust, when it comes to credibility. There are these voluntary commitments that many insurance companies have made to reduce waste, increase efficiency, and really pledge for better health outcomes.
this book will offer insights that will help them make good on that promise and on those commitments. Yeah, thanks.
Host
sounds amazing. Where can people find the book? What's the best place to get it?
Cynthia Overton
The best place to get the book is on Amazon. And yeah, it's available on Amazon. I am in the process of updating my website. I haven't quite gotten there yet, but in the process of updating the website with more bits and takeaways that are offered for patients, know, providers and payers are going to have to buy the book.
Host
Mm-hmm.
Cynthia Overton
But patience, I want to make sure that they have access to the information. So I'm starting to just post more and more on the website. I'm also in the process of starting, is not quite there yet, but I'm in the process of starting to post things on Instagram where I'll just be reading excerpts from the book for folks who might be interested.
Host
Nice. I love it. So it's called the clear cane Chronicles. You can get it on Amazon and it's by Cynthia Overton in case anybody missed your name right at the start of the episode, but it's easy peasy. If it's on Amazon, you can get it pretty quick and pretty seamlessly. Thank you so much for being on the podcast and sharing your story. really do appreciate it.
Cynthia Overton
Yes.
Cynthia Overton
Yes.
Cynthia Overton
Thank you, John. It's a pleasure.
