The most effective care happens when patient engagement is central to the process, not just a check mark on a box related to a business decision or government mandate.
Editor's Note: Welcome to Medical Economics' blog section which features contributions from members of the medical community. These blogs are an opportunity for bloggers to engage with readers about a topic that is top of mind, whether it is practice management, experiences with patients, the industry, medicine in general, or healthcare reform. The series continues with this blog by Henry Anhalt, DO, who is in private practice treating pediatric patients with type 1 diabetes. He is also chief medical officer for T1D Exchange, a nonprofit organization. The views expressed in these blogs are those of their respective contributors and do not represent the views of Medical Economics or UBM Medica.
Dr. AnhaltThe most effective care happens when patient engagement is central to the process, not just a check mark on a box related to a business decision or government mandate. Patients who are engaged decision-makers in their care tend to live healthier lives and experience better outcomes.
Today, however, physicians are under significant pressure when it comes to time and resources. According to a study by KLAS, only 10% of healthcare organizations are successfully engaging patients to maintain wellbeing1. Physicians often barely have time to cover the basics, let alone focus on patient-centered care.
While there have been great strides in how doctors encourage patient engagement since the start of my career over 20 years ago, there are a number of ways we should still improve. Here, you will find three tips I believe to be crucial to fostering patient engagement:
Twenty years ago, patient education was not comprised of much more than handing out pamphlets in the office. Today, patients have a wealth of online resources where they can learn more about their condition and potential treatment plans, without stepping into their doctor’s office.
Next: "As a physician, it's extremely important"
But not all of those resources are equally reliable.
As a physician, it’s extremely important to guide patients to resources that are both helpful and credible. In order to do this, I like to ask where my patients prefer to go for information and support. I reach out to nonprofits and foundations and I learn what’s available so I can make appropriate recommendations.
More importantly, I get involved. As a pediatric endocrinologist, what my patients and I talk about in the office is one thing, but 99.5% of care is happening outside of my office in the real world. That’s why I volunteer my time at Camp Nejeda, a camp for kids with T1D. There is no better training ground than experiencing their real-world challenges right along with them. T1D may be unique, but any chance to learn outside of a clinical setting, regarding any disease will be extremely beneficial for physicians.
Additionally, as a way to gauge patient comprehension, I like to ask my patients to explain their condition to me in their own words. I am often surprised how much they know, or don’t know about their ailment. This open dialogue allows for patients to be honest about their understanding of their condition, and also provides an opportunity for the physician to foster a dialogue of understanding and support.
As with many things in life, anxiety about an ailment is oftentimes related to lack of knowledge. Informed patients often have a more positive outlook on their condition and are more likely to take greater initiative in their health.
Next: Encouraging patients to engage in their health
Like many chronic conditions, type 1 diabetes (T1D) requires patients to be in-tune with their physical condition 24 hours a day. However, T1D is unique in that patients not only constantly monitor blood sugars, they also make treatment decisions all day long. They decide when and how much insulin they need to take to maintain good glycemic control; where under-treating blood sugars with insulin can lead to complications over time and over-treating can lead immediately to severe hypoglycemia, an acute event that can be deadly.
There are so many complex factors of living with T1D that while a doctor can provide education, guidance support, the utmost responsibility of treatment relies squarely on the patient.
As a physician, it’s our duty to provide patients with the tools needed to treat themselves outside of a doctor’s office. For my T1D patients, one resource I recommend to them is search online for a community dedicated to those living with type 1 diabetes. Through these portals, patients can learn, share experiences and communicate with others facing challenges posed by living with the disease, and they can also participate in research through online surveys and questionnaires.
This can also be empowering to the patient because it allows them to use their voice to drive and direct important research.
Even with non-chronic conditions, I advise physicians to encourage their patients to take measures outside of the doctor’s office that are essential to maintaining a healthy lifestyle. By encouraging preventive measures, patients will remain active in the maintenance of their health and will make fewer trips to the doctor’s office.
Next: "I strong advise physicians" to do the following...
Lastly, I strongly advise physicians to use each and every patient interaction as an opportunity to learn how to effectively engage with your patients. For example, if I’m treating a patient who has had a severe hypoglycemic episode, it’s going to inform the way I engage with that patient. I may decide to adjust their treatment plan, or I may increase my communications with the patient to create more dialogue between us in an effort to improve their care.
That kind of event will also change how a patient manages their own health. For example, if a patient experiences a hypoglycemic episode, it may result in distrust or lack of confidence in their doctor, on whom they place the blame for the incident. It’s important to use experiences like these as a learning opportunity for both patient and doctor and also to re-evaluate the relationship to establish or rebuild confidence and trust.
In general, the healthcare environment is complex and many patients struggle to obtain, understand, and effectively communicate their own basic health information.
As physicians, it’s our job to ensure our patients understand their health, even at the most basic level, so they can take control of their own well-being - resulting in a happier, healthier, more engaged life. While there is more than one way to encourage patient engagement, start applying these tips directly to your patient interactions and you may well see a marked improvement across the board.
 Patient Engagement: Rhetoric Turns into Reality, KLAS, December 2015