By Stephen Wilkins, MPH

First Posted at Mind the Gap on 9/16/2013

Steve Wilkins, MPH, host of "Mind the Gap"

Steve Wilkins, MPH, host of “Mind the Gap”

An Interview With Adopt One! Challenge Advisory Board Member Nancy Freimark, PhD

Here’s a recent interview I did with Nancy Freimark, PhD, an Adopt One! Challenge Advisory Board Member.  Nancy is a strategic communications consultant currently working in telehealth.  She is the former Director of Communications & Regional Director of Market Research for Kaiser Permanente in the Northwest where she worked for 15 years.

What is the big deal with physician-patient communications.  Why is it so important?

“What’s the big deal?” That is often the first question that comes up in health care strategic planning sessions when the conversation turns to patient-physician communications. Senior leaders, impatient for results and schooled in Six Sigma process improvement techniques, will suggest the solution is quite simple. “Just tell the docs to smile more.” Then the discussion turns to activities that can be measured and managed such as through-put, performance, and optimizing Medicare reimbursement rates.

The big deal with patient-physician communications is the fact that doing it well can be both measured and managed because its downstream effects are observable and impressive. Patient centered communications is the lynch pin that holds together every other success in the health care environment. Communications is essential for establishing trust during the patient experience, encouraging adherence to a treatment plan, and generating positive clinical outcomes.

The argument has been made that patient physician communications skills are already high in the United States. A quick look at the various third party rating systems like HEDIS and HCAHPS indicate that most physicians are rated at 95% or better on patient communications. But these scores are a bit of statistical illusion because everyone can’t be in the top five percent of anything unless they live in Lake Wobegon where everything is above average.

More objective measures of the patient experience tell a different story. Deficiencies in communications lead to longer hospital stays, lack of compliance with treatment plans, less than optimal clinical outcomes, and a majority of patients not understanding what they were told by their doctor. In addition, nearly half of all Americans have health literacy problems including not being able to read or follow written instructions. From a stone cold business perspective, less than stellar performance in patient physician communications results in patient churn (patients leaving to find another physician or medical group) and reputation management issues.

How do think busy physicians and their teams might potentially benefit from participating in the Adopt One! Challenge?

Pursuing excellence in patient-physician communications is the new reality of health care. Gone are the days of medical paternalism where the physician issued directives and the patient did what they were told. Today’s health care consumers, aka patients, are their own advocates and expect to partner with their physician. They want to share knowledge, be respected for their opinions, and, most importantly, they want to be heard.

There are those who would make the case that information technology can do the same or better job of engaging and activating patients as the in-person office visit. What do you see the role of health information technology being in relation to clinicians when it comes to physician-patient communication before, during and between visits?

Health care technology can help improve the depth, breath and speed of patient physician communications by improving the sharing of knowledge and connectivity but technology is best used to enhance an already effective relationship. Without first mastering patient physician communications, no advancement in technology will increase productivity or engagement.

If you could make a recommendation to your physician, what one patient communication skill would you suggest they pick to work on and why?

Continual improvement in communications is the success formula for any customer facing enterprise, health care included. A great place for any physician to start is to focus on “Sharing the Why.” Too often, physicians and other medical staff assume the patient understands the “why” of an intervention (ie. It’s for your health, for your safety…), a recommendation, or a course of action. The specifics of the “why” are left unstated with the blank to be filled in by the unknowing patient. Critically important for improved patient-physician communications, therefore, is to prioritize the “why”. Encourage understanding. Ask probing questions. Leave time for information to be processed. Check for true understanding. Then check again.

The social contract between the patient and physician is evolving and that change requires everyone in the health care industry to learn how to be 21st Century partners. The most essential skill to leveraging an effective partnership is to embrace patient centered communications. It is the key to improved patient satisfaction, outcomes, retention, and revenue generation – all things that can be measured and managed.

More About Nancy Freimark, PhD

She has extensive experience leading customer-focused communications and market research strategies in the health care, government, and advertising/marketing industries.