Want to be more patient-centered in your patient education? Hear about one common challenge to patient-centeredness, and how to handle it.
I recently had a client ask me for help with being more patient-centered in general. And one of the challenges they were facing is one I’ve seen a lot, and I’ve definitely faced it myself a lot over the years. I’ll tell you what it was and how to manage it.
Hi everybody, I’m Dr. Anne Marie Liebel and this is 10 Minutes to Better Patient Communication, recently ranked #20 of the top 100 podcasts in the social sciences by Goodpods.
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So I recently had a client ask me for help with being more patient-centered when they interacted with patients. The thing is, these folks were already very on top of things in terms of their awareness, empathy, bias, trauma-informed. The problem was they felt they sometimes struggled to bring those values through to the ordinary, everyday interactions with patients as much as they wanted to. And, yes, I do often get to work with people like this, who are already very knowledgeable and very sophisticated about the complex realities of doing equity-centered work.
I’ve also had a few of these people as guests on the show, so I’ll put some links in the show notes if you’re looking for some patient education inspiration.
Because ultimately, we want to reduce avoidable health disparities. So we’re all trying to integrate health equity into core processes. And patient education, super smart place to focus. It’s effective across patient scenarios, across diseases. It’s applicable to many departments’ work. You’re talking about patient safety, patient experience, quality improvement. Now, to get down to reducing those avoidable health disparities, I think we’ve all heard that we need to work at systems levels and individual levels. So what I’m going to talk about today, this challenge that this client and other people have faced, including myself, is I think interesting because it’s a system-level issue that becomes a problem for us individually. And it can be tough to track and tough to notice.
And I want to talk for a moment about this, about learning how to do this kind of stepping back and noticing things you hadn’t noticed before. Because I had been teaching for about 10 years before I started a doctoral program at the University of Pennsylvania. And we started learning about structural obstacles. And I think when people hear structural level or institutional level, our minds can go right to policy. And definitely, policies are one way that structural level effects can get felt at the individual level.
Well, there’s a whole lot more ways that structural level concerns make it into our day-to-day. And when I was finding out about this, it just about knocked me over because there were things that had been right there the whole time, and I had just never seen them, even though they were all around me.
So this client that I was working with, it wasn’t that people didn’t already have the skills and have their hearts in the work–and they were committed to equity! It’s that we’re working in systems and models that have been around a long time and exert a lot of influence. We’re talking about our organizations, institutions, our professions, our disciplines. They have their own ways of doing things, their own cultures, traditions, logics, expectations.
And on top of this, just being alive and part of society today means we’re all part of and involved in larger conversations about what it means to be healthy or what healthy people look like, or do,
or who does health properly. Conversations that reflect ways of thinking that are some generations deep. And these larger conversations are very powerful. They count as systems-level influences too. They can also be tough to spot because they’re so normalized.
And that’s part of why putting on equity lenses is so important. I’ve talked about this before, equity lenses, “putting on equity lenses” is a popular kind of phrase because the idea is when you put on lenses and you look at something that you’ve looked at before, suddenly you’re seeing anew. You see things you didn’t notice before. So I want to tell you about this systems-level issue, how it becomes a challenge or can become a challenge at an individual level, and what to do about it.
So a structural level reality that can become an obstacle at times for a lot of us is when there is a sense of urgency or a real time crunch, time pressure, or we’re over-scheduled. And I mean, honestly, this happens for most of us most of the time.
But this particular structural-level reality shows up in a quirky way when it comes to educating.
I’ve noticed over the years that in these situations, professionals tend to focus on what they have to say. That in itself is not a problem. You should focus on what you have to say. It can become a problem when that’s as far as we go. You’ve got information, you get right down to delivering it, and that’s the headspace you’re in. Maybe you fall into like delivery mode, informing, telling, focus on what we have to say, “the spiel,” as one physician called it, getting through the spiel.
This becomes a problem if we become more spiel-centered than patient-centered.
One negative effect of this kind of delivery mode is that it can have us over-focus on our role and under-focus on the other person’s role. It’s true, in the patient education scenario there’s huge amounts of pressure on you. You’ve got a plan, you’ve got to get through it. Focusing on what you have to do makes sense. What you have to say, the questions you need to ask, the data you need to gather, the answers you need to confirm, the form fields you need to fill out, your side of the process in the educator role. Focusing on this is completely understandable.
The task then becomes reminding ourselves to make room for the other adult in the room. That adult who has their own experiences, knowledge, worldviews, priorities, worries, things to say. Things to say about themselves, things to say about the topic at hand.
So the next time you are about to enter a room, enter a conversation with a patient, make some conversational room for that person. This can be as simple as:
- taking a statement you were going to state and make it a question instead.
- Give them chances to correct your understanding of them and what’s going on with them. You can ask, “what did I miss here?”
- I’m going to be so bold as to suggest you get them talking as much as you are talking.
It will help you both if you make time to let them contribute as much to the conversation as you do. This takes intentionality. I’m gonna drop links into a wonderful interview with Jonas Attilus and how he takes a learner’s role in patient education.
If you wanna get better at this, I have a course, Equitable Patient Education. Because it’s not a mystery. These kinds of structural-level obstacles are known. And managing them is what I help people do. This course has an on-demand portion, videos that you watch when it’s convenient for you, but then you, me and your colleagues, we get together, we meet live, we talk about it, we get down to work. I call it courses + action. Because that’s what it is! If you want more information visit HealthCommunicationPartners.com or again you can message me on LinkedIn.
This has been 10 Minutes to Better Patient Communication from Health Communication Partners. Audio engineering by Joe Liebel. Music by Joe Liebel and Alexis Rounds. Thanks for listening to 10 minutes to better patient communication from Health Communication Partners LLC. Find us at HealthCommunicationPartners.com.