Patients often don’t get the respect they deserve. Take the subject of patient engagement.  Just about everywhere you turn in the health care literature these days we are told how physicians and other providers need to do a better job getting patients involved in their own health.

But is that really their role?

Patient engagement is not the job of health care providers

Why?  Because by the time a person (aka patient) presents for care in the primary care physician’s office, they are already engaged in their own care to some degree (albeit now necessarily in the way providers expect).   Here’s what I mean.

People consult with their doctor when they have a need or concern which they believe needs to be addressed.  Often times before they make an appointment to see the doctor, people will do their own home work to see if a doctor’s appoint is really necessary.   Many of us for example will talk with a friend or family member or consult our favorite health website before deciding to see a doctor.  A recent Wolters Kluwer poll on health found that of all people who go online for health information, 50% do so before seeing their doctor.

Next we must pick up the phone and make the appointment which itself requires time and dedication given office hold times.  Then we must actually keep the appointment — telling ourselves that we are seeing the doctor for a good reason.

By the time we walk through the front door of the doctor’s office we are already engaged in our health as manifest by the cognitive involvement and expenditure of time involved with:

1. Deciding that we need to see a physician
2. Making and keeping their doctor’s appointment despite the self-talk that we will get better on our own
3. Preparing a mental list of issues/question that we want to discuss with the doctor

Given that people 50 years and older see their physician and average of 3-4 visits a year, they are already engaged in their own health — at least up until the time they walk into the physician’s office.

What happens in the doctor’s office plays a big role in determining whether the patient’s level of engagement grows, or is diminished if not extinguished.  Physicians that are prepared for the visit, ask patients for their input, solicit patient expectations, beliefs and previous experiences, and where possible honors them, are demonstrating traits that patients find engaging, e.g. traits which encourage patients to persevere in their get involved in their health.  Physicians who appear rushed, “not present,” not prepared, or who fail to solicit the patient’s input often have the opposite effect.

What is the role of providers when it comes to patient engagement?

Given that patients is the office are already engaged, albeit perhaps not is ways providers think of as engagement, the role of the provider is to create an atmosphere which facilitates, cultivates, and builds upon the level of engagement which patients bring to the office.  This is accomplished when the physicians and provider staff consistent employ patient-centered communications with all their patients.

Steve Wilkins is a former hospital executive and consumer health behavior researcher who blogs at Mind The Gap.

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