Better Health: Smart Health Commentary Better Health (TM): smart health commentary

Article Comments

Is Doctor-Patient Communication Better In “Medical Homes?”

Probably not yet. I think everyone would agree that Group Health of Seattle probably has a pretty good “take” on issues dealing with primary care redesign and the patient-centered medical home (PCMH). That’s why I surprised by a recent comment on a Group Health blog from by Matt Handley, M.D., in response to an earlier post here about patient question-asking. Dr. Handley is an Associate Medical Director for Quality and Informatics at Group Health.

Dr. Handley writes:

“While doctors often take pride in how open they are to patient questions, our self assessment doesn’t match up very well with empirical evidence. A recent post on Mind the Gap summarizes a small study that is relatively terrifying to me –- the take home is that doctors spend very little time explaining their recommendations, and that patients rarely ask questions.”

I picked up the phone and talked with Dr. Handley about his comments and work being done on PCMH at Group Health.

Then it struck me. If a medical home project on the scale of Group Health hadn’t substantively addressed improving the way physicians and patient communicate (i.e., encouraging patient question asking, etc.), what’s the likelihood that any other PCMH pilot would be addressing this problem?

The truth of the matter is that it does not seem that the problems of physician-patient communication are being substantively addressed (at least publicly) by any PCMH pilot. Nor are they addressed to any significant degree (beyond reference to recording the patient’s communication preference) by NCQA’s Medical Home Certification Criteria.

Yes, Group Health has extended the length of the office visit from 15 minutes to 20 minutes. Yes, Group Health and many other PCMH pilots have implemented e-visits, along with electronic patient record technology. But nowhere along the way have these initiatives taken steps to systematically improve the quality of the physician-patient dialog. As I cited in a previous post, simply increasing the length of the office visit will not automatically turn an otherwise autocratic physician into an empathetic patient-centered communicator. Physicians will need new tools, training and help from patients to become better communicators.

I think the patient-center medical home, and its funding partner the Accountable Care Organization (ACO), hold great promise for both patients and physicians. Like any innovation, their success or failure will rests on people’s ability to effectively communicate with one another.

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

You may also like these posts

    None Found

Read comments »

Comments are closed.

Return to article »

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…

Read more »

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…

Read more »

See all interviews »

Latest Cartoon

See all cartoons »

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…

Read more »

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…

Read more »

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…

Read more »

See all book reviews »