[Excerpt from upcoming book, Prescribing Change: How to Make Connections, Influence Decisions and Get Patients to Buy Into Change]
There is a growing body of evidence that highlights the potential benefits of patient-centered care for clinical outcomes, patient’s health and provider’s financial performance. For example, several hospitals that encourage patient-centered care by paying greater attention to patient’s needs and preferences have found that adverse events decrease, operating costs decrease, malpractice claims decline, length of stays are shorter, and the hospital’s costs per case decline.
Similarly, heart attack patients who did not receive patient-centered care were found to have worse long-term outcomes. Their overall health and likelihood of experiencing chest pains was higher than patients who received such care. A study of patient-centered nursing interventions for cancer patients found that the interventions were correlated with improved patient self-representation, optimism, and sense of well-being.
Despite numerous studies highlighting the benefits of patient-centered care and its correlations with better health outcomes and quality of life, studies have also concluded that patients often are insufficiently involved in care decisions. Fewer than half of patients receive clear information on the benefits and risks of treatment options, and fewer than half are satisfied with their level of control in medical decision making.
Studies have found that patients and clinicians often have differing views on the importance of different heath goals and health care risks. Other studies have found that physicians have inaccurate perceptions of their patient’s health beliefs, often assuming what’s important or relevant to the clinician is aligned with what’s important to the patient. When patients become active participants in their care, this misperception improves. Unfortunately, not only are patients frequently not involved in their care, but they are often interrupted by their doctor before having an opportunity to fully express their concerns.
Do patients desire more control and involvement? According to Pew Research Center, 80 percent of Internet users now seek health information online, making this the third most popular Internet activity. Patients are also seeking information on diagnoses, tests and prescriptions to learn more after a doctor’s appointment.
As a healthcare professional, you would likely acknowledge that a primary role of yours is to educate and inform the patients that you treat. While this is certainly an important responsibility of healthcare providers, education and information alone does not have much impact on your patient’s health and outcomes if it doesn’t get the patient to act on the information.
All your patients who smoke know that smoking is bad for their health. Every patient of yours who is on multiple medications and overweight (barring factors outside their control) knows they need to lose weight and take better care of themselves. They’ve been told this by every doctor that they’ve seen. In eye care, we routinely tell people the risks of ultraviolet radiation to the eyes, only to watch many people decline the option to wear sunglasses.
For years medical professionals have operated under the premise that patients need information and instructions on what to do. While patient education is an extremely valuable component of patient care, it often proves to be an ineffective approach when patients are not active participants in their care.
Because you’re an expert, most patients will politely agree with what you tell them, or at least give the appearance of agreeing. The question becomes, is the patient committed to what you are asking him or her to do, or just politely bobbing their head up and down to indicate they are hearing what you are saying?