As a patient, how do I get my healthcare provider more engaged in my care plan?

The goal of any relationship between a healthcare provider and patient is that both parties feel they are invested in favorable health outcomes. How they get there is the question. The underlying assumption is that a high degree of engagement from the provider and the patient will result in better outcomes, costs less, and may have higher satisfaction.

Engaged healthcare service is about actions and behaviors of both the provider and the patient. It takes two to have engagement.

What does a higher level of engagement mean? being involved. Being engaged means connecting; sharing; learning; achieving; contributing with a partner.

Some attributes of a healthcare provider being engaged are:

• Accessible
• Approachable
• Attentive
• Empathetic
• Intellectually honest
• Respectful

Some attributes of a patient being engaged are:

• Actively involved in their healthcare plan
• Complying with treatment recommendations
• Asking questions
• Confident and trusting
• Asserting

High level of engagement is related to but doesn’t automatically result in a higher level of satisfaction from the patient. As an example, when my rheumatoid arthritis pain flares my self-assessment is that I’m highly engaged and actively participating in the care plan. But I’m not satisfied with the results as I still have disabling pain. Alternatively, I can be very satisfied with the care received from the provider but not actively engaged in my own treatment plan.

There is a significant amount of research on how healthcare providers can strive to increase patient engagement. However, there is not a lot of information how a patient can strive to increase the level of engagement by the healthcare provider. It takes two to have engagement.

So, what can the patient do if they feel their provider isn’t actively engaged with them? Or, if they feel their concerns aren’t being listened to or if the provider appears rushed or is even arrogant?

The patient does have some options. They can seek mediation from health system support services. Or they can choose to fire the healthcare provider and seek the assistance of another healthcare provider.

Or, they can try talking to the provider about their feelings.

As a healthcare provider, I have struggled thru many “Come to Jesus Meetings”. I am not a trained counselor or mediator. What I am sharing is using the concept of reverse engineering.

As a healthcare provider I have learned and practiced tactics and strategies to encourage a patient to become more engaged. My thinking is these tactics and strategies should be applicable in my role as a patient receiving healthcare services.

Motivational Interviewing:

Healthcare providers are taught in order to increase the level of engagement by the patient to use a technique of “Motivational Interviewing”. This is a client-centered counseling style for eliciting behavior change by helping client to explore and resolve ambivalence. It includes rolling with resistance; open-ended questions; affirming; reflective listening; and summarizing. It involves evoking expectations and being empathetic. A patient can use this same process to increase the level of engagement of their healthcare provider.

Communication:

An article by Donna Zulman MD in the Journal of the American Medical Association identifies practices for healthcare providers to foster patient-client engagement including:

• Prepare with meeting with intention
• Listen intently and completely
• Agree on what matters most
• Connect with the Patient’s story

As a patient we can reverse engineer this information to increase the level of engagement of the provider.

Prepare with intention: A patient can prepare by writing down clearly and concisely the current state of symptoms, current medications, and questions needed answering. Be specific. Be factual. Share expectations. Many healthcare systems have email portals available. Use this to share your agenda of upcoming meeting ahead of time.

Listen intently and completely: A patient can use “talk back”.  Let me tell you what I understand my options are. What I hear you saying is.

Agree on what matter most: Be sure to share with the healthcare professional what matters most for you. Be aware some healthcare professionals assume patients are not interested in participating in the decision-making process. Ask what are my options?  Ask which is most important?

Connect with the Patient’s story: Acknowledge that you appreciate the efforts and skills of the healthcare professional. Give honest complements. Ask, how can I help you solve this difficult problem? This is what I see what would you recommend? Be specific with facts. How are you contributing to or adversely affecting the healthcare providers expectations? Consider what does the healthcare provider want from this provider-patient relationship. It is likely they expect respect of their time. They are genuinely concerned about accurately identifying the problem and solving the medical issue and concerns of the patient. want to look good because they helped solve a complex medical/health problem.

If you choose to have this type of conversation with your provider, Celeste Headlee author of “We need to talk” has shared ideas when difficult conversations and communication is needed. Her general advice is:

• Be respectful
• Be curious
• Check your bias
• Stay the course
• End well

If you think your healthcare provider isn’t as engaged as you need them to be consider having a conversation about your expectations. Keep in mind any successful relationship is a two-way street. It means connecting, sharing, learning, achieving, and contributing. Get actively involved in your care.

Damien Howell Physical Therapy – 804-647-9499 – Fax: 866-879-8591 At-Home, At Office, At Fitness Facility – I come to you, I do home visits Damien@damienhowellpt.com