Person-centered Care Means that Patients Count…A Lot

Changes in today’s healthcare system call on patients and families to take more active roles in their own health and in the care they receive to maximize that health.

“Person-centered” care is a significant aspect of the emerging healthcare model. Person-centered care values patients’ unique preferences, needs, and values, and ensures that all clinical decisions align with those preferences, needs, and values.

No longer are patients the passive recipients of care in which doctors make the decisions and patients simply comply.

Instead, a new vision for healthcare calls for clinicians to forge trusting and collaborative relationships with patients so that patients get the care that not only is medically appropriate, but care that delivers outcomes that are most meaningful to patients and families.

Everyone Needs to Do Better…and Why

To make these changes effective, both clinicians and patients need to do better by changing they ways in which they have traditionally interacted. Clinicians need to listen better so they can learn from patients and gain insights from the experts; that is, the patients themselves because they know themselves best.

At the same time, patients must be more proactive and effective sharing their stories and advocating for themselves in ways that help their clinicians give them the best care.

When everyone does better listening and sharing, everyone benefits. For patients, that means greater satisfaction with the care they receive, better self-care, improved outcomes, improved quality of life, and a greater sense of trust and loyalty. For healthcare professionals, such an approach can increase job satisfaction and reduce burn-out, reduce cost, and improve efficiency and diagnostic accuracy.

Three Simple Steps to Take an Active Role

In this spirit, two emergency-room physicians, Drs. Leana Wen and Josh Kosowsky, have written a book, When Doctors Don’t Listen, designed to help patients become better advocates for their own health and the care they receive from clinicians.

What are some of the key takeaways from the book:

Becoming an effective advocate for yourself requires good communication skills. Drs. Wen and Kosowsky offer three strategies to make sure you are heard when you interact with healthcare professionals:

First, Share the “What”

Tell people caring for you what’s bothering you.

It sounds simple, but you need to tell your actual story, not just list your problems and/or symptoms. When you share your story, include information about the timing, pace, onset, severity, context, and changes over time. Help your care provider “see” what’s happening with you by “showing” them rather than just “telling” them.

Try some of these tips:

  • When you describe what is happening, start at the beginning and proceed chronologically. Tell it like you would tell a story.
  • Make yourself notes with key points as markers, so you don’t forget something that you think is important.
  • Try not to fixate on exact times and dates if that will throw you off. Try to relate to the events happening in your life, such as, “the pain came right after I was eating breakfast.”
  • Share how you diagnosed yourself by describing how you got from noticing the pain or problem to deciding you needed to see the doctor, “It felt exactly like the last time I had kidney stones.”
  • Use simple language and only terms you are comfortable with. Don’t try to use medical-speak
  • Include the things you are most worried about. If you keep your fears inside, you will not learn the answers to the things that most concern you.

Then, Share the “How”

How is your problem affecting your life? How is what you’re experiencing complicating or interfering with the things you need to accomplish every day?

Try some of these tips:

  • Tell it just like you would tell it if you were telling a friend: Share all the details that are important to you and not just what you think that he or she might want to hear.
  • Share context from your life. For example, if the pain is so bad it made you skip golf, and you “never skip golf, even when you are in pain,” make sure to share that information.

Finally, Make Sure to Share the “Whole Enchilada”

What does your healthcare provider need to know to help you most effectively?

Make sure that you assert yourself as a patient by sharing your own insights given your own experience and expertise in recognizing what’s important to you. Nobody knows you better than yourself. Talk about what and how your feel.

Above all, don’t let yourself be railroaded, interrupted, or ignored if you think what you have to offer might make a difference in your desired health outcome.

What If Your Doctor Needs Your Help to Be a Better Listener?

If your doctor or nurse doesn’t seem to hear you because they’re doing things such as: interrupting, directing the conversation, skipping over your concerns, etc, take action and help them be better listeners with the following tips:

  • Don’t let your healthcare provider put words in your mouth or tell your story for you. Say, “Let me tell you in my own words so I’m sure you’re getting it right.”
  • Include all of the things that you are worried about, not just your chief complaint. This might help your provider relieve your stress and/or widen their search for what is happening with you. “I know that the reason for my visit today is ‘X,’ but I want you to know that ‘Y’ also has me concerned. So, I’d like us to address that, too.”
  • Don’t be afraid to start again. Ask to start again from the beginning if your provider still does not seem to be getting the larger point or what you were hoping to communicate. “I’m not sure I made it clear, so let me try again so I know you understand what’s happening with me…”
  • Always be sure to be courteous and respectful while you move the visit to what you want to discuss. The more courteous you are, the more likely you will get the attention you desire as a partner in your own healthcare. “I appreciate what you’re saying. Just so we’re on the same page, please let me explain…”
  • And always make sure that you get the answers to all of the questions you have before you leave the office because you have every right to be fully informed in regards to your own healthcare. “Thanks for the time you’ve taken with me today and for your recommendations. Just so I make sure I have it right, I want to ask a last question…”

Have you struggled with communicating with your doctor or other healthcare provider? What methods of communication have you found effective in taking a more active role in your care? Share your experiences, leave a comment.