By Dr Irwin Lim, Rheumatologist
33 members of our BJC Health team just completed a tiring weekend learning about HealthChange Methodology.
Our physiotherapists, exercise therapists, massage therapists, dieticians, rheumatology care coordinator, admin & reception staff, and our rheumatologists all together. Confronted by information and tools to help us improve our ability to help our clients/patients change behaviour.
The truth is compliance in healthcare is poor. I'm not sure what the best available stats are but I have an inkling that compliance with taking medication is probably around the 50% mark. I'd imagine compliance with exercise prescription and dietary changes are likely to be lower. Follow through with smoking cessation advice is likely to be abysmal.
So, we wanted to learn how we could improve patient/client compliance and adherence. We wanted to learn how to better engage patients in their own care. Basically, to be more effective in delivering good outcomes.
A core component of what we learned was the need to be much more Client Centred. Clients/patients need to be given choice and control. The way we conduct consultations need to become much more Client Centred.
I still have to process the stuff we learned over the coming weeks and months.
But I thought I'd share one simple change I'm going to make.
Seeing patients day-in day-out, I'm guilty of forgetting that for patients coming to see a rheumatologist for the 1st time, there may be quite a degree of anxiety and uncertainty.
Is this the right doctor for me? Why do I have to see another health professional when I've seen so many already? What is he going to do different? What is a rheumatologist?
We actually sat down to try and work out how best to address this at the start of the consultation, quickly and efficiently. How should I introduce myself? How should I allay these fears?
I've been a doctor for 18 years. This shouldn't have been as hard as it seemed. Good thing my colleagues were there to help & we had good facilitators.
Anyway, this is the workflow/spiel we came up with:
(I walk to the waiting room & call out the patient's name)
Mr David Smith...
Hello, my name is Irwin (handshake)
Please come this way. Please have a seat.
Can I start by finding out what you would like to be called/addressed?
I am a rheumatologist. Have you seen one before?
Well, let me explain my role. I'm a specialist in arthritis; in problems affecting bones, joints, muscles & tendons; and in immune diseases.
(helps reinforce that the patient is seeing the correct doctor)
David, could I please ask what's your understanding of why you are here?
Good. Well, by the end of this consultation, what I hope you'll take away is a better understanding of the problem and a plan to help you manage that problem. I'm here to work together with you to develop this plan.
Is that what you are expecting?
(Benefit statement -> patients should know what's in it for them. The patient should also feel involved & respected)
What do you think of getting this style of introduction? Does it help you as a patient to have the specialist you are seeing describe what they do up front? Is it obvious they are there to help you or does it actually help if the health professional actually articulates how they plan to help?Dr Irwin Lim is a rheumatologist and a director of BJC Health. You should follow him on twitter here. Arthritis requires an integrated approach. We call this, Connected Care. Contact us.