The media is full of stories about providers’ influence on the patient experience. Less common are articles about how patient engagement influences provider satisfaction—and the vicious cycle generated by lack of patient engagement, provider dissatisfaction, and poor outcomes.
Consider these statistics:
- 50% of patients don’t follow their treatment plans.
- Up to 70% of hospital readmissions occur from patients neglecting their care plans.
- Roughly 7% of the malpractice claims examined in one recent analysis involved a lack of patient engagement.
For already overburdened providers, numbers like these can be disheartening. Providers have a strong desire to help people; they feel good when patients are engaged and meet their goals. Conversely, it’s frustrating for providers to watch patients experience poor outcomes due to a lack of engagement in their care plans.
Disengaged patients also typically require extra coaching, counseling, and appointments, which add extra time and administrative burden to providers’ workloads. Equally stressful is the knowledge that, at any moment, providers may find themselves embroiled in litigation despite their best efforts to care for patients.
In today’s environment of escalating patient disengagement and disrespect—even violence—toward providers, it’s easy to feel emotionally exhausted, morally distressed, and devalued. Yet providers are not powerless.
As one Medical Group Management Association (MGMA) insight article observes, “Health care professionals influence the development of patient activation.” That’s crucial because activated patients participate in their care and are proactive about maintaining their wellness. Indeed, a 2022 literature review indicates that activated patients need fewer visits to achieve successful outcomes—which is exactly what brings joy and meaning to providers’ work.
Our takeaway is this: Providers have the power to help patients become more engaged—and, in so doing, also increase their own satisfaction. Research suggests providers can turn a potential downward spiral into positive, “turbo-charged” patient/provider relationships.
So, where do we start?
Data lights the way.
While scrutinizing the malpractice claims data noted above, signals emerged regarding where providers should focus their patient engagement efforts. Specifically, the analysis found that among malpractice claims involving lack of patient engagement:
- 71% of patients had at least one comorbidity, with the most common being diabetes, smoking, and hypertension.
- 59% of the cases (and 67% of the indemnity paid) involved diagnosis- or surgery/procedure-related allegations.
- 60% of the cases began in an office/clinic or surgery setting.
- 55% of the cases involved surgery and general medicine specialties.
- 34% of the cases (and 65% of the indemnity paid) involved either high injury severity or death.
This intelligence suggests that engaging medically complex patients (e.g., those with comorbidities) in an office setting is beneficial, especially when discussing diagnoses and related procedures. Communication skills may hold the key to engaging patients, reducing noncompliance, and improving outcomes.
Communication is the key.
Poor communication often contributes to malpractice claims. Conversely, good communication before, during, and after a patient encounter can turbo-charge the patient/provider relationship. Best of all, it’s something providers can control.
Here are eight tips providers can use to support effective, compassionate communication that makes patients feel heard, valued, and engaged:
1. Explain the practice’s “ground rules.” Good communication starts before patients walk through your door. Ensuring patients understand both their rights and their responsibilities can help prevent unreasonable expectations.
2. Give clear instructions. Before their appointments, let patients know how to prepare and what to bring with them. Encourage them to bring someone to the visit with them if they need additional support.
3. Identify and address barriers to care. Social determinants of health are often a factor in noncompliance. So, have upfront conversations to uncover financial, transportation, language, or other possible barriers. If possible, help patients address identified barriers through community resources.
4. Encourage conversation. In addition to exhibiting positive bedside manner, encourage conversation by greeting patients warmly, introducing yourself (as appropriate), and starting the visit with an open-ended question such as, “What brings you here today?” Listen actively to be sure your expectations for the visit match the patient’s expectations. Use plain language to describe what the visit will entail and why, and the treatment plan. Offer the patient plenty of opportunities to ask questions.
5. Understand your patient’s goals. Any disconnect between a provider’s treatment goals and a patient’s treatment goals can create friction and disengagement. That’s particularly true when comorbidities such as diabetes, hypertension, and smoking or COPD complicate the treatment plan. Therefore, it’s important to understand each patient’s goals and priorities, and then determine whether they are feasible.
6. Be kind but direct. Candid discussions about the consequences of noncompliant behavior can help patients better understand their treatment plans. But remember that patient portals may now give patients access to your visit documentation, too. That means your word choice can affect patient engagement. Documenting in plain, positive language such as, “Patient with BMI of 34 and persistently elevated hemoglobin A1c” is more likely to win patient compliance than a note that reads, “Obese, noncompliant Type 2 diabetic.”
7. Manage treatment expectations. In conjunction with understanding your patients’ goals, it is imperative to make sure they have realistic expectations about their potential outcomes. There should be no ambiguity about what constitutes a good result. This communication is especially valuable in cases where a range of possible outcomes exists.
8. Listen attentively when patients express dissatisfaction. When potential conflicts arise, an honest and compassionate conversation is often the best first step toward resolution. A calm, collaborative discussion that shows patients you are listening and trying to address their needs may be all that is necessary to restore the relationship.
Fortunately, lack of patient engagement is a modifiable risk factor. It does require some thoughtfulness around establishing expectations, nurturing good communication, and proactively resolving any potential conflicts. However, with these strategies in place, abundant opportunities exist to kick-start a positive cycle of patient activation and better outcomes—with improved provider satisfaction along the way.