Patient Empowerment

Overcoming Shame

This insecurity is the biggest challenge in my practice: getting people to change their behavior.  Somehow I have to somehow get people to pay attention to their health when they\’d rather ignore it, to be taking medications when they\’d rather not, to be exercising when they don\’t want to, to lose weight when they love cheeseburgers, and to be checking their blood sugars when they\’d rather not know how high they are.  After trying lots of things over the past 20+ years, the one thing I find almost never works is what is usually done: lecturing the patient.

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Noncompliant Patient-Centeredness

If you look up the word \”compliance\” in a thesaurus, the first synonym (at least in my thesaurus) is \”obedience to.\”  This implies that non-compliant patients are, at least to some degree, equivalent to disobedient patients.  This is borne out by the reaction many patients seem to expect of me when they \”confess\” they haven\’t taken prescribed medications: they look guilty — like they are expecting to be scolded.

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Patient Centered Care

The real question I am asking here is not if this care is good or bad (the answer to that is, yes, it is good and bad), but whether it is patient-centered.  

This should be a silly question, like asking if car-repair is car-centered.  But it is clear that much of the high cost of care in our country is due to the huge number of unnecessary procedures, medications, hospitalizations, and services given to/done on people.  Unnecessary care is, almost always, not patient-centered.  

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Patient Centered Service

The vast majority of people truly want a doctor they respect and actually like.  This may come as a shock to many of my jaded colleagues who routinely face the ire of people stuck in waiting room purgatory, ignored or disbelieved by doctors, and treated as objects instead of people.  They think that people are angry because they don\’t like doctors.  They view the people on their schedule as, at best, the hungry masses they must placate and, at worst, as their adversaries they must conquer. Then they wonder why their patients are so unhappy?

The past three years has taught me otherwise.  People want to like their doctors.  We just haven\’t given them any reason to do so.

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Patient Centered (Part 1)

Rather than dwelling on the malfunction of the system, however, I want to turn my eyes toward what most people don\’t see: what real patient-centered care could and should be. It\’s not that I am suddenly wiser than my colleagues in the sick-care system.  Despite 18 years in practice, I was not able to see what true patient-centered care looked like until I left the system. 

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Personal Tech

When I say we need more tech, I am not saying we need more computerization so we can produce a higher volume of medically irrelevant word garbage.  I am not saying we need to gather more points of data that can measure physicians and \”reward\” them if they input data well enough.  The tech I am referring to is like that I used regarding my father.  I want technology that does two things: connects and organizes.  I want to be able to coordinate care with specialists and to reach out to my patients.  I want my patients to be able to reach me when they need my help.  Technology can do this; it sure did for my dad.

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Target Demographic

He seemed a bit grumpy when he came into the office.  I am used to the picture: male in his early to mid-forties, with wife by his side leading him into the office to \”finally get taken care of\” by the doctor.  Usually the woman has a disgusted expression on her face as he looks like a boy forced to spend his afternoon in a fabric store with his mother.  My office is the last place he wants to be.

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