Healthcare Debate: Time Or Diagnosis?

verbal joust

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.

Screen Shot 2015-11-20 at 2.12.58 PM

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)

As always, you can feel free to contact me at: CANCERGEEK@GMAIL.COM or follow me on twitter @cancergeek



2 responses to “Healthcare Debate: Time Or Diagnosis?

  1. diagnosis used to be a factor, where I had a choice or multiple choices in care. Now I get that to a degree with specialists elsewhere (regionally) but a good share of the local docs/HCPs I see don’t really know my illnesses. To me, they don’t have to know the ins & outs. They just have to listen to basics & be willing to listen. Which, the majority to. I think it speaks volumes if I do keep tabs on studies & I approach them with it to pick their brains. Used to be I’d try to do that with other docs elsewhere & it was called being a pain in the neck. When really I was trying to do is see if I would realistically qualify in the first place & if in my situation it was worth pursuing. I will say the one time I had to see an oncologist for an anomaly (uncertain potential situation, not benign not malignant which to me was worse because no one knew what turn it would take) (even just 50 cases in literature back then, & a handful of researchers), she was on top of it & managed & coordinated everything. Even involved me in seeking two other opinions to confirm the original biopsy which she would not have had to do. All of this made the situation inherently less stressful by default, at least at the beginning & where she was involved and concerned. What you say is true: “The level of patient engagement is proportional to the level of empathy, active listening, and relationship building we exert on our end.”
    I’ve seen how key this is between professionals as well, not just their patients. You would not believe how much easier it all gets when any type of collaboration is offered, versus just a one-shot or a straight & narrow silo’d approach. Then again you can, because you do it & #GSD. (Words to Live By 4 Life)

  2. Pingback: Mayo Clinic Center for Innovation | Is It The Time or Diagnosis That Builds The Ideal Patient Experience

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