Physicians have little control over how well patients take care of themselves at home, acknowledged Elizabeth Pector, M.D., a family medicine physician based in Naperville, Illinois, in a recent article for Medical Economics.
The following techniques are among those Pector has found most effective in motivating patients to follow recommendations:
- Enlist your team. Managing a population of poorly controlled diabetics, for example, is a tall order for one person. Pector's hospital-owned medical group leaders brainstormed solutions to this very problem and implemented a half-day diabetes clinic, point-of care testing and a patient education program. With more focused attention, many of the patients have gotten their health back on track. Practice employees aren't the only ones who can help contribute innovative ideas; patient advisory panels can be invaluable in quality improvement efforts as well.
- Make it doable. Simplify your patients' medication regime as much as possible so that patients can actually follow it, Pector recommended. This means eliminating unnecessary prescriptions and giving preference to drugs that are taken less frequently and cost less.
- Be willing to walk away. If patients truly aren't doing their part to help you maintain a therapeutic relationship, consider a pre-dismissal letter to express your concerns. Within the letter, set a clear goal for patients to prevent dismissal, such as labs and visits within six weeks. "I state that their nonadherence is weakening the physician-patient relationship so I can't effectively help them … and warn that my next regretful step would be dismissal from practice with 30 days of emergency care until they find another doctor," Pector wrote. "This has brought nearly all my delinquent patients back into the fold."
To learn more:
- read the article from Medical Economics