I hate saying I told you so.  But "patient engagement is a physician-patient communications challenge and not an HIT (health information technology) challenge.” Just take a look at the Mayo Clinic’s patient portal experience which was discussed at a HIMSS 2013. The headline: "Mayo Clinic struggles to meet stage 2 meaningful use thresholds for engaging patients." Always innovating, the Mayo Clinic some three years ago introduced a web-based portal to share information with ...

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Each of us wears many different “hats” throughout the course of the day.  We are an employee, a wife, a father, a club member, a consumer and so on.   It comes as no surprise that our thinking, what we say, and how we say it at any particular time coincides with the hat we are wearing at that moment.   The thing about these “hats” or roles is that they come ...

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Physicians, hospitals and other providers are being misled by  industry pundits claiming that more health information technology (as in EMRs, PHRs, smartphone apps, and web portals) is the key to greater patient engagement.   It’s not. If health information technology were all that was needed to “engage” patients then  patient and member adoption rates of provider and payer web portals offering personal health records (PHRs) and electronic health records (EHRs) would not ...

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I talk with lot of physicians about the need to improve the quality of communications between physicians and patients.   Regular followers of my work will know that I am an advocate for the adoption of patient-centered communication skills by the physician and provider community. Physicians with whom I talk seldom disagree as to the need for better physician-patient communications.   They know that physician communication skills top the list of patient complaints ...

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Turns out that while most of us (90%) would like be able to make a doctor’s appointment and check lab results online. 85% of us also still want the option of be able to talk to our physician face-to-face.  These are the finding from a recent 2012 study conducted by Accenture. These finding will no doubt come as a surprise to many of those high tech newcomers to health care looking ...

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Accountable Care Organizations (ACOs) and “bundled payments” are set to play a central role in the Affordable Care Act.  Under accountable care, physicians and hospitals would be paid out of a “single payment” from CMS or health insurers for all the care needed to treat a clinically defined “episode of care” like a heart attack.   The premise is that bundle payments will incentivize physicians and hospitals to deliver more efficient, ...

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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) ...

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Can you say “reactance”?  Don’t feel bad, I wasn’t familiar with the term either until recently.  But as you will see, anyone that has ever been a patient will catch on pretty quickly as to what reactance is and how it works. Reactance is how we respond to something that threatens to limit or eliminate our behavioral freedom.  I recently experienced reactance in the course of “prepping” for a colonoscopy.   The ...

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Primary care physicians are the point of first contact that people like you and I have with a hospital or health systems.   We are 13 times more likely to visit a primary care physician in any given year than we are to need a hospital stay. Primary care physicians are very important.   Yes they are they the first line of care for many people.   The primary care physician’s office ...

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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? ...

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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 ...

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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 ...

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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, ...

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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 ...

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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 ...

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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 ...

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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.  ...

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"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 ...

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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
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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 ...

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