It is said that "turn around is fair play."So if providers (physicians, hospitals and other health care professionals) expect patients to become more engaged in their own care, isn’t it fair for patients to expect their physicians to also get more involved in their care?If you look closely at "proxy measures" for physician engagement, you will see that this is a legitimate if not equally important line of inquiry.Hello? Hello? ...
Steve Wilkins, MPH
Patient engagement is the holy grail of health care
For health care professionals, patient engagement is the holy grail of health care. It is the key to patient adherence – a prerequisite to achieving better outcomes, fewer ER visits and hospitalizations and more satisfied patients. It is easy to recognize an engaged patient – they do what their health care providers recommends …what their health care team knows what is right for them.But doesn’t engagement depend upon your perspective?In ...
The therapeutic value of touch in medicine
My wife has two world-class oncologists who help her manage her stage 4 lung cancer. Both are excellent clinicians. Yet their skills differ in one very important way. Her radiation oncologist physically touches her a lot (in a good way of course!). There are the touches on her arm, a hand on the shoulder, hugs, and of course a thorough hands-on physician exam. Her medical oncologist not so much.We all ...
Why hospitals and physicians should get serious about patient-centered care
Health care professionals are a cynical lot. We joke about the "fad or buzzword of the month," usually some vague concept heralded by the powers on high. Our job is to promote the idea, knowing full well that the "next big thing" is probably right around the corner.Take "patient-centered." It sure feels like a buzz word. I suspect most hospital and physician executives, and their ad agency partners, ...
Top 5 myths about empowered patients
Irrational exuberance was a term once used to describe the stock market before the last crash. It also seems an apt description for much of the talk these days about empowered health consumers.To be sure, patients today have unprecedented access to health information. Patient decision-support tool can be found on just about every provider, payer and self-insured employer website. Consumers can go to any number of websites to find ...
Unintended consequences of standardizing physician practice
Turns out there is an unintended consequence of many of the current efforts to standardize the way doctor’s practice medicine. It is called de-skilling. De-skilling can occur when physicians and other providers try to adapt to standardized, new ways of doing things. Examples of such standardization include clinical based care guidelines, electronic medical records (EMRs), pay for performance (P4P), patient centered medical home (PCMH) requirements and so on.Examples of ...
Think about mindfulness when seeing a new patient
I had a "wow" experience recently when I accompanied my wife to interview a new doctor for her. As some reader may know she is being seen by specialists at MD Anderson Medical Center in Houston for Stage IV lung cancer. She has not had a local oncologist for the past 6 years, but she does now. And we both love this guy!You need to understand that I have ...
Unintended consequences of patient portals
There seems to be an inverse relationship between the amount of spin one hears about "the next big thing" and reality. First it was EMRs and virtual e-visits, then social media, and now patient portals seem poised to be next big thing. The drumbeat of vendors and pundits is unmistakable: physician that don’t adapt will be toast. It can all sound pretty convincing until you ask to see the evidence. ...
Why doctors can sometimes be their own worst enemies
"I don’t have the time … I don’t get reimbursed for that." This is an all too common refrain from primary care physicians and practice managers when ever the subject of improving physician-patient communications comes up.I get it. Primary care physicians in particular are under tremendous pressure to produce. Just imagine, physicians in small primary care practices spend about 3.5 hours per week just on dealing with insurance-related paperwork. Then ...
Why patients should change their doctor
Sure you are comfortable with your current doctor, after all you are still alive and kicking. Besides it has taken you years to figure out what you can safely tell your doctor and when it’s ok to speak up.Yes, the fact that your doctor is often late and never seems to listen to you bothers you just a little. You aren’t displeased enough to stop giving your doctor high
How physicians should deal with angry patients
I highly recommend you take a look at "10 Dumb things you do at the doc’s office." Be sure to scan the article, but what you really need to look at is the comments, all 700+ of them.While by no means a representative sample of how we think about physicians, there is a clear pattern to the comments. A lot of people feel disrespected by ...
Benefits of chance meetings with other cancer patients
My wife had just finished meeting with her medical oncologist for her bi-annual check-up at MD Anderson’s Thoracic Clinic.We were sitting in an area called "the Park" rehashing what her doctor had said when a mother and her daughter sat down at our table. There were lots of empty seats in area but for some reason they decided to sit with us. Call it serendipity. ...
How denying patient requests may not impact patient satisfaction
Does physician denial of patient requests result in decreased patient satisfaction?The short answer: No.At least not in the context of a strong physician-patient relationship.Many physicians have legitimate concerns about the prospects of having their salary or level reimbursement linked to patient satisfaction. I would too given the way most health ...
Why depression continues to go undiagnosed and untreated in primary care
What medical condition is the most costly to employers? I’ll give you a hint. It is also a medical condition that is likely to go unrecognized and undiagnosed by primary care physicians.If you guessed depression you are correct. If you mentioned obesity you get a gold star since that comes in right behind depression for both ...
Does empathy mean giving patients what they want?
Recently, KevinMD.com picked up my post on empathy or should I say the lack of it. I received some engaging comments.One comment in particular caught my attention.The contributor for some reason equated “being empathetic” with “giving in” to patient requests presumably during routine office visits. Here’s a direct quote:
Give the patients what they want! Antibiotics are OK for colds. The patients want them. So ...
Empathy and the physician patient relationship
Is anyone else tired of hearing about how important empathy is in the physician-patient relationship? Every other day it seems a new study is talking about the therapeutic value of empathy. Enough already!It’s not that I don’t believe that empathy is important, I do. I also believe the data that links physician empathy with improved patient outcomes, ...
Is patient adherence responsible for health quality and safety?
A while back I did in a post where I asked the question, What can patients really expect from their physicians today? In that post, I wondered at the fact that many patients still have a high degree of trust in their physician in spite of the quality and safety problems attributed to physicians in the press.For example:
- On average, US adults receive only 50% of recommended ...
A medical home does not guarantee increased patient satisfaction
One of the more notable findings from the special report on the TransforMED National Medical Home Demonstration project was that “patient satisfaction doesn’t automatically go up.”Terry McGeeney, CEO of TransforMED, attributed the lack of increased patient satisfaction experienced by the 18 participating physician practices to a variety of factors, chief of which “was the turmoil of change experienced by patients as practices implemented after-hours access, quick access to laboratory results ...
What can patients really expect from their physicians today?
It may seem odd during these turbulent, cynical times, but a lot of people still trust their personal physician. People that have high trust in their physician tend to believe that their physician;* Is up-to-date with the latest medical treatments * Keeps track of all important aspects of their health during and between visits * Can be depended upon to act in the patient’s best interestThis broad-brushed view of patient trust ...
Patient beliefs and their role in non-adherence
Patient non-adherence is a big problem. Non-adherence among chronic disease patients is associated with higher rates of hospital re-admissions, higher costs and poorer outcomes.Research has identified over 200 possible factors thought to influence patient adherence. According to the experts, these factors can be categorized into two groups:1. unintentional non-adherence 2. intentional non-adherence.Unintentional non-adherence is related to a patient’s ability and resources to take their medication (e.g., problems with manual ...
