Written Oct 29th, 2013 by Franco Varriano
Industry Leaders Share Tips on Improving Patient Compliance
Patient compliance is not a new challenge in the field of medicine, but it is arguably one of the most important challenges doctors face when treating patients. Because we now live in a world where we have the technology and tools to tackle this age-old problem in refreshing ways, Fullscript decided to approach two of our most active practitioners for some advice.
Dr. Vincent Pedre is an MD who runs an exemplary integrative health practice with a blend of both Western and Eastern medical traditions in NYC.
Dr. Jaie Bosse runs a very successful naturopathic practice, Illuminating Health, in Philadelphia.
Not surprisingly, both stated that patient compliance is tough because it begins well before the patient enters your office and it does not end when the patient walks out. There are factors you can’t control, such as the patient’s state of mind on that given day, but there are many factors you can control (and we will talk about them below). Being aware of these factors will help you communicate better with your patients and ultimately help them improve. The first step of course starts with…
The simple act of truly listening can have a profound effect on the patient’s willingness to listen to your suggestions. A great example that Dr. Pedre provided, which is all too common, is when a patient walked into his office having already seen 3 doctors. They had all sent her away to a psychologist because they believed it was all in her head. This patient, as it turns out, had true digestive and stomach problems.
Dr. Pedre adds:
“People want to be heard and people want to be acknowledged. The first thing is to listen and bond with the person, to acknowledge their story, to repeat and make sure you’re getting the story right, showing them that you believe in their story. All that engenders trust in the interaction.”
Listening ensures to the patient that the treatment plan you suggest is tailored to their specific needs and not just a cookie cutter solution. As a result, they are more likely to follow through.
Once you believe you have heard the patient and understood their story, the next and most crucial step is to take the time to educate. All too often, doctors prescribe a treatment plan to a patient without explaining why it was prescribed, which often leaves the patient confused and unaware of its importance. Taking the time to educate patients is especially important in this day and age because as soon as patients leave your office, they are going home and searching the web to verify the validity of your treatment plans. But since they do not have the proper scientific training, they may become swayed by the wrong information.
Here Dr. Pedre offers some practical advice on maximizing the effectiveness of how you may educate your patients.
“It’s important to tailor your communication style and message to the way that they understand and learn. It may be that you use an analogy or draw a picture. I might draw a picture of the gut to show them what a leaky gut means.”
There are many other ways to educate your patients on their treatment plans, but the fact that you did will make all the difference.
Previously, when a patient leaves your office, there is little else you can do to ensure they stick to the plan. However, now you can effortlessly send follow-ups and check-ins to your patients virtually between visits. Follow ups are not only great as a gentle reminder, but also as an opportunity to gauge resistance from patients - especially after they had a chance to do some self-research. Furthermore, even though you may be repeating the same explanations to a patient multiple times, circumstances change and so will their receptiveness to what you have to say. It never hurts to repeat. ;)
Dr. Pedre relays a perfect example of how he was able to use technology to uncover hesitation and help the patient ultimately reach his health goals.
“I had a patient who wanted to lose weight and part of his issue was carb cravings so I spoke to him about a fibre supplement called PGX that he’d take with the meal to help fill up his stomach faster. Through using Fullscript, I saw that he created an account, but then I saw that he didn’t purchase the supplements I had suggested for him. So I went back and emailed him saying I noticed you created a Fullscript account and wanted to see if you have any questions about the supplements I recommended. I simply opened the door for him to come back to me and tell me what he was thinking.
My gut feeling was that there was resistance here and I was right. The reply came - he wasn’t sure about the supplements. He misinterpreted and thought the prescriptions were vitamin supplements. He also works in the news industry so he referenced several news articles, which gave me the opportunity to go back and give him a thorough response based on my clinical experience, which helped clarify what he may read in a news article or study because each person is different and not everyone is covered in studies. I had to go back and forth a few times and ultimately it is to his benefit and convinced him that this was a good plan of action for him.”
4. Lowering the barrier
Even when a patient has been properly heard, educated, and followed up on, he/she may still not follow through. After all, it’s hard to break a habit that has been years in the making. Dr. Bosse makes a great suggestion on lowering the barrier in forming new habits.
“Instead of completely overhauling someone’s diet, I’ll start by asking them to eat two more vegetables each day. Also, I have a weekly checklist of “basics” including sleep, water, fruits, veggies and exercise that I ask them to hang on their fridge. The paper itself acts as a visual reminder and the act of checking off completed tasks is motivation to continue.”
Habit forming is one aspect of the barriers patients face, but another more practical barrier might simply be the cost. We know from experience that many patients are quite eager to start their treatment plans and resolve the health issues that have been bothering them for years, but they don’t always have the financial means. This is why we now allow practitioners to give out discounts to specific patients to help them out a little.
Let us know if you have any thoughts or tips on improving patient compliance in your practice!