21 Dec Healthcare Debate: Time Or Diagnosis?
Post Written By Andy DeLaO
Another verbal joust between Mike (@uscaspecialist) and I this week was on the topic of patients, engagement, and getting shit done.
I shared a few observations with Mike:
- “Satisfaction” always seems to be highest in oncology departments
- Patients seem to be more inquisitive, informed, and active in their care
- There are a number of instances in which patients come back to see how members of the care team are doing, and to share their own life events and updates
- There is always a tray of goodies left for the oncology staff from patients and family members
- In a department that informs patients of life altering events there is an abundance of smiles and hugs
Which brought me to my hypothesis:
Time with patients builds the trust, which leads to the formation of relationships; The relationship provides an environment for patients and physicians to share transparently and enables patients to be active (“engaged”) in their care.
So I asked:
Is it the diagnosis or the time that allows patients to be more “engaged” in their healthcare?
Mike brought up some very good scenarios based on his own experiences. His initial response was that the diagnosis drove a patients’ motivation. We talked through diabetes, congestive heart failure, cancer, and general health. We discussed some of the challenges based on insurance, access to care, constraints on physicians, production values (those dreaded RVU’s), and the need for patients to understand instructions and follow them accordingly.
In many of the stories Mike ended up mentioning the word “time” as he addressed and identified challenges, barriers, and success stories. He mentioned that he believed #ChronicLife and a chronic diagnosis drove behaviors.
However, each time Mike spoke, I reminded him that he was mentioning the word “time.”
In radiation oncology, we tend to see patients 5 times a week, for 6-8 weeks, for 10 minutes.
In medical oncology, we tend to see patients 1 day a week, for 8 hours, every 3-4 weeks. (varies based on chemo regimen)
Diabetic patients may see a physician for 15-20 minutes a day, one time every 3-4 weeks, for 6 months upon first diagnosis.
A healthy adult may see a physician once a year, for 15 minutes.
With the cascade of time we spend with patients, we tend to also see a decline in the level of engagement and active participation.
I believe that time trumps all in any business.
Amazon, Walmart, Target, Marriott, Audi, Apple, and healthcare. Time is a basic factor in our decision making process.
In healthcare, time may be the most important factor in our decision making process. It may not be inherent and obvious, but it is the basis of our choices.
Humans are short term thinkers. If I make a choice I want to see immediate benefits. If I want to lose weight, I expect to lose 10 lbs in a week. (thank you diet pills, Tony Horton, and Sean T) If I walk 10,000 steps I want to see benefits today; don’t tell me that the benefits happens 30 years down the road.
However, when we are told a story that changes the perception of our own time, we are motivated to engage and become active participants in our health and care.
Most important (in my opinion), is our need for a meaningful relationship with other people. Having another individual that is vested in my story, that is willing to listen, share, and provide support and guidance to me; a person I trust will often compel me to do my part to keep the relationship. If you show me in a way that is simple, easy to understand, and actionable I will make the effort to do my part.
Show me how to improve my perception of time, and I will do the work.
In my opinion, it is not the diagnosis that drives a patients level of engagement.
It is time.
The level of patient engagement is proportional to the level of empathy, active listening, and relationship building we exert on our end.
The next time you have an opportunity to meet with a patient……remember:
A patient can use their time as they wish; they chose to spend and use their time with you. Make that time priceless. Use the time to build the #MyIdealPtExp
Put the #MeInMedicine
And Get Shit Done!! (#GSD)