When it comes to patient outcomes it’s not a question of the most advanced technology that provides the best care; It boils down to communication. At its most fundamental level the physician/patient relationship is about the interaction and what is expressed and what is understood.
Oftentimes I will see medical practices marketing body scans and advanced blood work. While it is exciting to think of a Star Trek type of practice where one is simply scanned and all health concerns are known we simply aren’t there yet. These body scans and extra blood work have never been proven to increase health in any way. Having an open dialogue with patients and allowing patients the time to tell their story is the best way to improve patient outcomes. There is an old adage in medical training: “90% of the diagnosis is the story.” If a provider doesn’t listen to the story then getting it right is that much harder.
It is estimated that up to 40% of hospital admissions could be avoided by better communication between the physician, the care team and the patient. It is distressing to think of all the suffering and needless waste of money that could be avoided by simply listening. By understanding patient concerns and getting feedback on medications and symptoms providers are better able to preempt healthcare deteriorations that land patients in hospitals.
Every provider has a different style, but I typically start out appointments by asking patients about what brings them into the doctor. I know the sorts of things that I want to address to keep them healthy: preventative measures, immunizations, blood work, etc. These are the issues that I want to address, but oftentimes you cannot get there until you address that nagging shoulder pain or other complaint that the patient has. From a patient standpoint, if you can’t take the time to deal with an ache or pain why bother dealing with an abstract issue such as cholesterol or hypertension.
At the end of every visit I review the plan and ask patients if there any questions. Sometimes I think we are communicating and in reality we just aren’t. I try as often as possible to make sure that I’m on the same page as my patients. On top of the willingness to communicate from staff and clinicians, there needs to be a general openness. If patients feel that they are being judged or that they are being pressured for time they’re less likely to tell a physician important information.
Sometimes questions come up after the visit has ended. Every patient has access to me via email and every email is responded to within a 24 hour period. By keeping messages in the patient’s own words it reduces the likelihood that information is lost in translation from staff to the physician.
Sometimes practices change over time and with the pressure to comply with government regulations and insurance demands the one-on-one that providers enjoy with their patients falls to the wayside. We have engineered our processes so that this doesn’t happen, even as we continue to grow. Communication is a core belief in our practice, and with such a small price and such a great reward it will always be front and center.
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