Friday, May 3, 2013

4 ways to beat time constraints and guide patients to better health


4 ways to beat time constraints and guide patients to better health

As doctors, we’re typically compensated for the work we do, not the hours we spend. Our jobs are structured so that we’re taxed for time, making even the most routine office visit feel like a race against the clock. Trying to develop a long-term strategy with a patient in this context is not time-efficient. It is, in fact, incredibly frustrating.
Yet medicine is a team effort, and we understand that we’re treating people, not algorithms. We know that when patients are more informed they tend to make better choices at home (eating healthful foods), and in our offices (scheduling things like flu shots). Here, four ways to work within our existing time-constraints to help patients shift the needle toward better health.
Direct patients to good information early. Office visits can be chaotic, and one easy way to offer some focus is to start the conversation beforehand. A page of links to credible articles, a series of posts or downloadable handouts, a few minutes of video content, or even just a list of “frequently asked” questions are all easy to add to your website, for example. Early in the appointment, open the conversation up to questions on these topics. Not all patients will have time to look at or think about them before seeing you. Many won’t. However, for those who do, by introducing common reference points, you’re saving time by creating a shared language and structured dialogue from the very start.
Make intake forms available ahead of time. Another great opportunity to maximize efficiency is to make your intake form available before the appointment. Once in the waiting room, patients can feel harried, nervous, or rushed. By filling the paperwork out at home, they not only have time and additional resources to give more considered answers, but they may develop new, relevant questions to bring to the table.
Monitor. When we weigh our patients or take their blood pressure, we’re relying on single numbers from particular moments to make complex diagnoses. We’re only getting thin slices of what’s going on with their health. However, we know that one of the greatest clues in medicine is change over time, so tap that resource. Ask your patients to monitor a few simple things, such as weight, or how much they’re exercising. Nowadays, there are countless devices that make it easy to track, upload, and even share this kind of data, giving you a much richer picture of what’s going on between checkups.
Re-evaluate. As you and your patients continue your conversation over multiple visits, you’re not just getting updates on their progress, but also a deeper narrative of their long-term wellness. On every return appointment, quickly re-evaluate your own advice to your patients on diet, exercise, medication, and specific actions taken based on their medical history (like early screenings). This gives you repeated chances to ask yourself if there are better ways to deal with any of the problems you’re treating.
There is an old adage that rings true in medicine: With enough data, error goes away. The hope is that this multi-pronged strategy of data collection will enable you and your patients to have the best outcome, time after time.
David B. Agus is a professor of medicine and engineering at the University of Southern California. He is the author of The End of Illness and blogs at ZocDoc’s The Doctor Blog, where this post originally appeared.

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