High Touch Matters: Longitudinal Trusting Relationships are Critical for Patients with Chronic Disease
Over the last couple of weeks, we have reviewed highly technical scientific facts about medications that are key parts of a protocol to address cardiovascular and related diseases like diabetes and hypertension. That is only part of the answer.
It does not matter how brilliant your care plan is, if your patient does not know that you really care about them as people. And that takes time. Seven minute office visits cannot succeed in chronic disease management. Trusting, long-standing relationships between your office and patients are critical elements of success in caring for patients with chronic diseases. It is not just lifestyle and medication protocols.
That is where teamwork is so important. A trusting relationship is vital, but many different members of the healthcare team can provide that function. ChenMed has made this part of their system. They manage patients with multiple chronic conditions in disadvantaged neighborhoods. Each patient gets a call from the office once a week, and a call from the doctor once a month. They achieve outstanding results. Another organization, the SouthCentral Foundation in Alaska, provides 85% of their care remotely. Only 15% of their patient encounters are face-to-face. They achieve quality scores in the 75th to 90th percentile while providing care for half the cost when compared with that provided for other Alaskans.
It takes time to know the biggest thing for Sally is being active with her grandchildren or that Phil wants to continue walking in the mountains. But only then can you help them understand optimal medical treatment is essential to maintain their health so they can continue to do those things. Hear their stories with empathy. When that trusting relationship is in place, Sally and Phil are much more likely to take the time and make the effort to adopt your brilliant recommendations.
Many organizations have pieces of the puzzle, but very few have designed and implemented a comprehensive solution to consistently provide optimal medical treatment for their patients. This ability to create trusting relationships remotely is especially critical now that the pandemic is ramping up again. I have been working to bring together resouces to support you in this effort. For example, I work with a nurse coaching company focused on diabetes that helps patients understand the value of optimal medical treatment. You may not have the time to build a trusting relationship and they cannot change prescriptions. Working together may improve your performance. Let me know if we can help. whbester@gmail.com
Boy oh boy, have you hit the nail on the head, Bill. Care management and coordination is still a much needed, and largely absent, part of our disease care system. Even in situations, like my own, where the several specialists who I see work for the same "health care system," the communication and coordination between and among them is almost non-existent. This leaves me with the role of "self care manager" and coordinator for things like medications, their dosages and side effects, which tests to take and which to avoid because of duplication, and so on. And I'm relatively healthy with no serious chronic illnesses! At one time, Family Physicians were going to take on this role, and many of them still try to do so today. But it has been a losing battle against procedural and for-profit medicine.