By using this site, you agree to the Privacy Policy and Terms of Use.
Accept
Health Works CollectiveHealth Works CollectiveHealth Works Collective
  • Health
    • Mental Health
    Health
    Healthcare organizations are operating on slimmer profit margins than ever. One report in August showed that they are even lower than the beginning of the…
    Show More
    Top News
    falsified drugs
    What Are the Health Risks of Falsified Drugs?
    July 15, 2024
    chronic disease
    The Role of Compliance Packaging in Chronic Disease Management
    November 4, 2024
    How to Deal with Ethical Dilemmas in Social Work
    How to Deal with Ethical Dilemmas in Healthcare Social Work
    March 6, 2025
    Latest News
    Beyond Nutrition: Everyday Foods That Support Whole-Body Health
    June 15, 2025
    The Wide-Ranging Benefits of Magnesium Supplements
    June 11, 2025
    The Best Home Remedies for Migraines
    June 5, 2025
    The Hidden Impact Of Stress On Your Body’s Alignment And Balance
    May 22, 2025
  • Policy and Law
    • Global Healthcare
    • Medical Ethics
    Policy and Law
    Get the latest updates about Insurance policies and Laws in the Healthcare industry for different geographical locations.
    Show More
    Top News
    (Some) Docs Launch War on Overutilization
    February 19, 2012
    Ribs on BBQ
    Meat and Mortality: Does Eating Meat Decrease Your Lifespan?
    March 10, 2013
    Match Day Looms, Can Primary Care Once Again Show Gains?
    March 15, 2012
    Latest News
    Let Your Lawyer Handle the Work Before You Pay Medical Costs
    July 6, 2025
    Top HIPAA-Compliant Messaging Apps for Healthcare Teams
    June 25, 2025
    When Healthcare Ends, the Legal Process Begins: What Families Should Know About Probate and Medical Estates
    June 20, 2025
    Preventing Contamination In Healthcare Facilities Starts With Hygiene
    June 15, 2025
  • Medical Innovations
  • News
  • Wellness
  • Tech
Search
© 2023 HealthWorks Collective. All Rights Reserved.
Reading: Stop Blaming the Patient and Fix the Real Problem – Poor Physician-Patient Communications
Share
Notification Show More
Font ResizerAa
Health Works CollectiveHealth Works Collective
Font ResizerAa
Search
Follow US
  • About
  • Contact
  • Privacy
© 2023 HealthWorks Collective. All Rights Reserved.
Health Works Collective > Business > Hospital Administration > Stop Blaming the Patient and Fix the Real Problem – Poor Physician-Patient Communications
Hospital Administration

Stop Blaming the Patient and Fix the Real Problem – Poor Physician-Patient Communications

Steve Wilkins
Steve Wilkins
Share
9 Min Read
SHARE

Yet another in a seemingly endless series of articles blaming patients for all that’s wrong in health care is running in Modern Healthcare.  The 3-part series entitled Channeling Choice looks at how patients (people like you and I) just aren’t making the kinds of choices and engaging in the kinds of behaviors experts think we are should.

Contents
It Takes Two To Tango – Mary’s Side Of The StoryUnfortunately Mary (And The Rest Of Us) Do Not Live In An Ideal WorldThe Take Away?Sources:

Yet another in a seemingly endless series of articles blaming patients for all that’s wrong in health care is running in Modern Healthcare.  The 3-part series entitled Channeling Choice looks at how patients (people like you and I) just aren’t making the kinds of choices and engaging in the kinds of behaviors experts think we are should.

doctor patient communicationLike so many of these articles, the Modern Healthcare series shares war stories of chronically ill people making poor health choices despite the well-intentioned efforts of local health care providers to “fix” them.  One such story bemoans how a heavy-set, low-income, congestive heart failure patient named Mary, paid more attention when grocery shopping to what something cost than its salt content…despite “being advised by her doctor” to do so.  Like so many “Marys and Martys,” the Mary in this story ended upon with multiple hospital admissions over a short period of time.  If only Mary had heeded her doctor’s advice.

It Takes Two To Tango – Mary’s Side Of The Story

In an ideal world, I could buy into Modern Healthcare’s conclusion that Mary’s choices and behavior were to blame for her condition and her outcomes.  Under the right circumstances I would even go so far as to suggest that Mary’s hospital and physicians not be financially penalized for her non adherent behavior and subsequent preventable hospital readmission.

More Read

5 Strategies For A Calm Staff Management During Covid-19 Crisis In Your Facility
Utilization Review vs. Utilization Management
A More Positive Outlook on Provider Consolidation
“Social Media Residency”: Essential for Tomorrow’s Physicians
How Cleveland Clinic Builds Brand Recognition via Multichannel Marketing

Mind you I said under the “right circumstances.”  What would the right set of circumstances look like?

Glad you asked.  In the ideal world at a minimum here is what I would expect to happen:

  • Mary and her doctor would be in agreement as to what is wrong, e.g., the diagnosis
  • Mary’s doctor reviews her treatment options with her and they engage in a shared decision as to the course of treatment
  • Mary’s doctor would validate Mary’s understanding of the above by employ basis “teach back” communication methods

Please take note of the importance of the physician’s patient communication skills in the ideal world.

Unfortunately Mary (And The Rest Of Us) Do Not Live In An Ideal World

In the real world, physicians’ patient communication skills are often anything but ideal. Here’s what I mean.

Mary and her doctor would be in agreement concerning the diagnosis – Patients have usually formed a hypothesis about their medical problem before seeing the doctor.  Agreement concerning the diagnosis at face value would appear to be a prerequisite to patient adherence (i.e. medication and dietary recommendations) and desired health outcomes.

It goes without saying that in order for physicians to know where patients are coming from concerning their complaint they need to ask the patient.  But that is not happening.   A recent study found that only 16% of physicians admitted to routinely asking patients their “perspectives” regarding their condition.

It should come as no surprise therefore that in a separate study of patients in a Cardiology Clinic over half (55%) of patient diagnosed with Congested Heart Failure were unable to accurately recall or agree with their physician’s diagnosis of CHF.

It is extremely unlikely therefore that Mary’s doctor sought her perspective concerning her condition opening the door to a lack of  agreement as to the diagnosis and what to do about it.

Mary’s doctor reviews her treatment options with her and they engage in a shared decision as to the course of treatment – Shared decision-making is a communication skill typically associated with physicians that routinely employ a patient-centered communication style with patients throughout the medical exam.   The evidence suggests that the majority of physicians today employ the same physician-directed communication skills they learned years ago in medical school.   Consistent with this trend, another study reveals that only 37% of physicians admitting to routinely engaging patients in shared decision-making (in whatever form that takes) meaning that again the odds are against Mary having been engaged by her physician in shared decision-making.

Demonstrates her understanding of the above by the physician’s use of “teach back” – Patient teach-back is a communication technique where the clinician asks the patient to repeat back what they were told to make sure the patient understood what was said by the clinician.   A 2012 study found that to the extent that patient teach-back is sporadically employed and only then in instances where the physician and patient were of a different culture, ethnicity or language.

In particular, patients who speak a language other than English, are of Black/African-American race/ethnicity, those with advanced age, and those with fewer years of formal education were more like to experience patient teach-back than their counter English-speaking, white, educated counter parts. Giving Mary’s clinicians the benefit of the doubt, let’s assume she had a 50-50 chance of have benefits from patient teach-back at some point in her treatment.

The Take Away?

The reality is that, like the rest of us, neither Mary nor her hospital or treating physicians live in an ideal world.  As such, one can make a strong, evidence-based argument that hospitals and physicians are just as culpable as patients, if not more so, for failing to employ the kind of patient communication skills needed to promote patient engagement, activation and effective self-care at home.

The health care industry over the last 100 years has done a great job of socializing people to assume the passive sick role when we seek care. In that role we are not expected to challenge physicians or question their decisions…in fact many patients are fearful of being labeled as difficult when they do take on such behaviors.

If hospitals, health plans and physicians expect patients to change their behavior, they themselves have to change the way their think about, communicate and relate to patients (aka people).   They themselves have to become truly patient-centered more engaging to patients…from the patient’s perspective!

As a first step, I suggest that hospitals, health plans and physicians stop blaming patients for everything that’s wrong with health care today.  Maybe then we can make some progress at collaboratively building on all that’s right with health care.

Sources:

Sarkar, U., et al.   Patient- Physicians’ Information Exchange In Outpatient Cardiac Care: Time For A Heart To Heart?.  Patient Education And Counseling.  2010.

Jager, A. , et al. Who Gets a Teach-Back? Patient Reported Incidence of Experiencing a Teach-Back.  Journal of Health Communication: International Perspectives. 2012. 17:sup3, 294-302.

Frosch, D., et al. An Effort To Spread Decision Aids In Five California Primary Care Practices Yielded Low Distribution, Highlighting Hurdles. Health Affairs. 32, no.2 (2013):311-320.

TAGGED:physician-patient communication
Share This Article
Facebook Copy Link Print
Share

Stay Connected

1.5kFollowersLike
4.5kFollowersFollow
2.8kFollowersPin
136kSubscribersSubscribe

Latest News

car accident lawsuit
Let Your Lawyer Handle the Work Before You Pay Medical Costs
Policy & Law
July 6, 2025
women dental care
What Is a Smile Makeover and How Much Does It Cost?
Dental health
June 30, 2025
HIPAA-Compliant Messaging Apps
Top HIPAA-Compliant Messaging Apps for Healthcare Teams
Global Healthcare Policy & Law Technology
June 25, 2025
recovering from injury
Rebuilding After Injury: Path to Physical and Emotional Recovery
News
June 22, 2025

You Might also Like

Digital Decision Maker
eHealthHospital AdministrationSocial Media

Internet Marketing and Healthcare’s Digital Decision Makers

July 22, 2015

A Legal Stimulant is Making People Crazy

July 21, 2011

Strategic Positioning for Healthcare Organizations

February 27, 2015
Telemedicine, Hospital Marketing
BusinesseHealthHospital AdministrationMobile Health

Telemedicine: Endless Possibilities for Hospital Marketers

November 7, 2014
Subscribe
Subscribe to our newsletter to get our newest articles instantly!
Follow US
© 2008-2025 HealthWorks Collective. All Rights Reserved.
  • About
  • Contact
  • Privacy
Welcome Back!

Sign in to your account

Username or Email Address
Password

Lost your password?