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 ...

Read more...

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 ...

Read more...

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, ...

Read more...

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 ...

Read more...

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 ...

Read more...

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 ...

Read more...

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.  ...

Read more...

"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 ...

Read more...

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
Read more...

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 ...

Read more...