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Changing Patient Behavior: Two Power Words

“I recommend.” These are two word which, when spoken by a physician to a patient have tremendous power to change behavior. That assumes of course a trusting relationship between patient and physician (but that’s a topic for another day.)
 
Take the colonoscopy. The U.S. Preventive Services Task Force (USPSTF) recommends that adults aged ≥50 years get a colonoscopy every 10 years. In 2005, 50 percent of adults aged ≥50 years in the U.S. had been screened according to these recommendations. Not surprisingly, the rate of colonoscopy screening is much lower than that of other recommended adult preventive services. I was curious: Why?
 
Here are two interesting facts:

1. Studies show that patients cite “physician recommendation” as the most important motivator of colorectal screening. In one study, 75 to 90 percent of patients who had not had a colonoscopy, said that their doctor’s recommendation would motivate them to undergo screening.

2. In that same study, in 50 percent of patients where a colonoscopy was appropriate but not done, the reason given was that the physician simply did not “bring up” the subject during the visit. Reasons included lack of time, visit was for acute problem, patient had previously declined or forget. Read more »

*This blog post was originally published at Mind The Gap*

Health Information: Who’s Using A Cell Phone To Find It?

What do cell phones and health-information seeking have in common? Very little, at least among the chronically ill (e.g., the folks who are driving healthcare use and cost). An American Medical News article about the latest Pew Research Center’s Internet & American Life Project study on mobile phone use caught my eye. The introduction to the article reads:

Despite the proliferation of cell phones in the United States, the number of people using them to access health information is low. But experts believe the sheer number of people using mobile phones and wireless devices means that health information eventually will get more mobile as well.

According to the study, 85 percent of Americans use mobile phones, but only 17 percent of cell phone owners have used them to look up health information. Nine percent of Americans have downloaded a health-related app on their cell phone.

Get this: The highest use of cell phone health-information seeking and downloading cell phone health apps was among 18- to 29-year olds at 29 percent and 15 percent respectively. With the exception of accidents, 18- to 29-year-old adults are generally among the most healthy demographic. Read more »

*This blog post was originally published at Mind The Gap*

Do Social Media Advocates Now Have Something To Cheer About?

Over the last year or two, lots of people have been jumping on the social media bandwagon, i.e., Twitter, Facebook, and so on. There has been a lot of talk about how social media and social networking will revolutionize healthcare, but little evidence to back this talk up. Until now, that is.

Before I get to the evidence that I referred to, I need to clarify something. The goal of social media as I understand it is to get people talking, sharing information and creating new ideas. As applied to healthcare, one of the goals of social media is to get people/patients with like medical conditions taking, sharing and supporting one another. Healthcare researchers refer to this phenomenon as peer support. Peer support is not new to healthcare. Disease-specific support groups (breast cancer, diabetes, etc.) have been around for years. “Group” physician office visits comprised of patients with the same diagnosis have been around for years as well.

The Study

Now to the evidence. As anyone with a chronic condition or who treats patient with chronic conditions knows, patient self-care is critical. Knowledge, skills and confidence are prerequisites for effective self-care management. Read more »

*This blog post was originally published at Mind The Gap*

When Patients And Doctors Disagree

A 69-year-old woman who swims in my master program came back to the pool after a total knee replacement. I asked her how she was doing. She said she is still in a lot of pain because of her physical therapy. She said that her physical therapist was disappointed that she still was still unable to achieve full flexion of 120 degrees. Why 120 degrees? Did you set that goal I asked her? “No,” she said, “the therapist did.”

She went on to tell how she already had more range of motion in her knee than she did before the surgery. My friend was quite satisfied with her progress and wanted to stop physical therapy. The pain from the PT was worse than anything she had experienced before the knee replacement. I knew she and her 80-year-old boy friend were going on a cruise and she didn’t want to still be hobbling around.

It turns out that patients and physicians disagree on quite a few things. We hear a lot about patient-centered care. You know, that’s where the provider is supposed to consider the patient’s needs, preferences, and perspective when diagnosing and treating health problems. But medicine is still very provider-centered. Read more »

*This blog post was originally published at Mind The Gap*

Latest Interviews

IDEA Labs: Medical Students Take The Lead In Healthcare Innovation

It’s no secret that doctors are disappointed with the way that the U.S. healthcare system is evolving. Most feel helpless about improving their work conditions or solving technical problems in patient care. Fortunately one young medical student was undeterred by the mountain of disappointment carried by his senior clinician mentors…

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How To Be A Successful Patient: Young Doctors Offer Some Advice

I am proud to be a part of the American Resident Project an initiative that promotes the writing of medical students residents and new physicians as they explore ideas for transforming American health care delivery. I recently had the opportunity to interview three of the writing fellows about how to…

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Latest Book Reviews

Book Review: Is Empathy Learned By Faking It Till It’s Real?

I m often asked to do book reviews on my blog and I rarely agree to them. This is because it takes me a long time to read a book and then if I don t enjoy it I figure the author would rather me remain silent than publish my…

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The Spirit Of The Place: Samuel Shem’s New Book May Depress You

When I was in medical school I read Samuel Shem s House Of God as a right of passage. At the time I found it to be a cynical yet eerily accurate portrayal of the underbelly of academic medicine. I gained comfort from its gallows humor and it made me…

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Eat To Save Your Life: Another Half-True Diet Book

I am hesitant to review diet books because they are so often a tangled mess of fact and fiction. Teasing out their truth from falsehood is about as exhausting as delousing a long-haired elementary school student. However after being approached by the authors’ PR agency with the promise of a…

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