4 Questions to Improve Health Outcomes

Written by on October 31, 2014 in Practice tips - No comments

When a patient arrives at the office to see the doctor, one would think the patient actively desires professional guidance for their concern.

On the surface this may appear to be reality, but multiple dynamics are at play to determine if your patient will follow-through with the prescribed course of treatment.

DocAndPatientWEBIf the help the patient receives is not in the form they desire, is not aligned with their values, or if the patient does not understand the reason for the course of prescribed treatment or the consequences of non-compliance, your patient is less likely to adhere to medical guidance. This leaves the patient’s complaint insufficiently addressed – which may exacerbate a medical problem – and the healthcare provider’s time wasted.

The days of assuming patient adherence because ‘I said so’ is over. Prescriptions go unfilled and lifestyle recommendations go unimplemented. Patients are the authority of their own body.

Advice giving and prescribed treatment do not solely resolve health concerns. A health coaching approach using Motivational Interviewing can increase your patient’s adherence to prescribed treatment, help you retain patients to your practice, and influence the health outcomes of your bottom line.

Below are 4 areas to assess to influence patient behavior along with sample questions to engage the dialog.

Note the quality of your voice tone and body language while engaging the patient is just as significant as the questions themselves. In order to share openly and honestly, patients must feel safe and not judged. Make solid eye contact with a soft gaze, have your knees face the patient, with your arms and hands uncrossed to signal receptivity and collaboration.

  • Assess Understanding of the Condition: Patients may not understand their diagnosis or how their condition may worsen if left improperly treated. To assess understanding, ask:
    • What is your understanding of how your condition affects the body?
    • What is your understanding of how your condition may progress if left untreated?
    • It can be common to not fully grasp your diagnosis. We provided educational materials during your last visit. What, if anything, is unclear to you about your condition?
  • Assess Importance of the Treatment: If the prescribed treatment is not important to the patient, the likelihood of adherence is minimal at best. To assess importance, ask:
    • How important is it to you to make the recommended lifestyle changes?
    • On a scale of 1-10, with 1 being not at all important and 10 being extremely important, how important is it to you to take your medication as prescribed?
  • Assess Barriers to Change: Good intentions do not improve health outcomes. Patients may have external barriers like finances, transportation, or lack of social support that prevent change. Internal barriers may include denial, guilt, or lack of confidence to implement change. To assess barriers to change, ask:
    • What barriers, if any, may prevent you from filling your prescription?
    • What barriers exist that would prevent you from making the suggested lifestyle changes?
  • Assess Confidence to Move Forward: When making lifestyle and behavioral changes, the patient’s confidence in their ability to implement change is critical to success. To assess confidence, ask:
    • On a scale of 1-10, with 1 being not at all confident and 10 being extremely confident, how confident are you that you can make the recommended changes?
    • How confident are you that you can make the recommended changes over the next month?

When barriers are discovered that the medical practice cannot sufficiently address because of time or lack of coaching expertise, consider referring the client to an experienced health coach. The health coach can partner with your practice and the patient to increase confidence and overcome barriers to change.

Assessing these four areas surface challenges that need to be addressed so the patient can experience the best possible outcome. If left unacknowledged or unexplored, the patient is more likely to be non-adherent or apathetic to medical care. When addressed with compassion and courage, the patient experiences greater quality of life while the healthcare provider rests assured the most effective level of care was provided.

By Angela Savitri, OTR/L, RYT
Certified Integrative Health Coach

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