Patient-centered

Overcoming Shame

10 Comments / Improving Health Care, Patient Empowerment

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.

Entering The Narrative

7 Comments / Being a Doctor, Improving Health Care

My hope is that somehow we are able to return to care that is patient-centered. People want their narrative to be a good one, and doctors need to be able to enter that narrative and become a positive influence.  Our goal needs to push people out of the medical realm and back to living the rest of their narratives with as little contact with the healthcare system as possible.  That\’s what patient-centered care really is.

Noncompliant Patient-Centeredness

15 Comments / Improving Health Care, Patient Empowerment

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.

Patient Centered Care

4 Comments / Improving Health Care, Patient Empowerment, The Healthcare Problem

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.