Consider this situation: a 62-year-old female patient was given a prescription for metformin at her previous appointment with her family physician. Now, at her current visit, results from her pre-appointment bloodwork show a hemoglobin A1C of 6.4%. Her family physician asks how she is doing with the metformin, but she replies that she didn’t fill the prescription!
What is the reason for the patient’s noncompliance with the prescribed therapy? Maybe she isn’t experiencing any symptoms, or she misunderstands the importance of better controlling her blood glucose, or she doesn’t want to become dependent on a pill. The overriding reason, however, is that she likely did not share in the decision to take metformin.
What Patients Want
Studies indicate patients want three main things from healthcare professionals:
- “Care about me.”
- “Listen to me.”
- “Show me empathy.”
Essentially, when patients say they want to be cared for, heard and understood, they are asking to have a voice in their own care. Patient engagement occurs when healthcare professionals encourage patients to develop the eagerness and capability to actively take part in their own health choices and management.
Benefits and Barriers
Engaging patients in their own care has significant benefits. It increases their compliance with healthcare recommendations, helps them deal more calmly with medical uncertainties and often improves their care outcomes.
Fostering patient engagement also decreases your professional liability exposure. Schoenfeld and colleagues conducted a simulation study to discover the impact of patient engagement and shared decision making on practitioners’ lawsuit risks. The researchers found that participants in the simulation who were exposed to any degree of shared decision making—brief or extensive—were 80% less likely to report a plan to contact an attorney compared to those NOT exposed to shared decision making. The investigators concluded that “respectful and patient-centered communication may be medicolegally protective.”*
There are, however, impediments to increasing patients’ involvement in their care: for instance, low health literacy, language barriers and patients’ perceptions of physicians as authority figures can block engagement attempts. But the biggest obstacle is lack of time. In today’s demanding clinical settings where visit times are short, healthcare providers may be pressured to pay less attention to patients’ emotional needs in order to meet the demands of the day’s schedule.
When you reflect on the facts that about 30% of prescriptions to patients aren’t filled, that many people neglect getting cancer screenings, that some patients don’t follow through on referrals, and on other comparable realities, you begin to understand that many decisions made at medical visits are not mutually agreed to by practitioner and patient.
By offering patients the opportunity to discuss proposed care with their decision partners (spouse, family, companion) and to plan for and accept new care regimens, healthcare providers can cultivate a form of shared decision making that tends to increase patients’ adherence to treatment proposals, experts say.
Patient engagement emphasizes connection, allowing healthcare providers to focus on human interactions instead of care transactions. These types of encounters are generally what patients say they desire and what healthcare professionals attest motivated them to choose a career in medicine.
LAMMICO/MI Educational Activities Can Help
Two education activities from LAMMICO/Medical Interactive Community elaborate on the benefits and obstacles associated with engaging patients in their healthcare decisions. These activities give time-sensitive strategies for encouraging patients to share in decision making. “Engaging Patients to Reduce Liability Risk: Part 1” describes two engagement techniques you may want to try—the SHARE Approach and the 3-Step Model. Part 2 of this series presents specific examples of how to use the two methods. LAMMICO insureds can access this education free of charge by logging in as a Member at lammico.com.
* Schoenfeld EM, Mader S, Houghton C, et al. The effect of shared decision making on patients’ likelihood of filing a complaint or a lawsuit: a simulation study. Ann Emerg Med. 2019;74(1):126-136.