10 Things Patients Wish We Knew

We talk a lot about focusing on patients, patient engagement, and patient-centered care, but then we turn around and recommend designer vitamins and expensive wearables for our Medicaid participants. Healthcare is often out of touch. Today’s article is a patient wish-list with some surprising requests from real people:

1. Respect the patient’s wallet. They want to know if they can pay for their care, and so do we – so let’s not hide the cost and then complain about the rate of accounts going to collections.
2. Include the patient when we talk about them. When they are in the room, we should not start our sentences with “ask the patient if…” It makes them doubt our observational skills when they feel the need to wave their hand and say, “I’m over here!”
3. Respect the patient’s time. If we can’t give them an appointment for six months, we should not ask them to arrive two hours early just to wait.
4. Listen to the patient’s questions. Our instructions are only as good as the patient’s understanding of them. When they don’t think their kidney disease is important, it is usually because we did not answer their questions about how serious the condition is.
5. Explain ourselves in plain language. Need I say more? (Just kidding.) If we don’t explain ourselves, we might end up in jail when the patient swears that we told them to overdose on a medication. (Yes, something like this actually happened). It’s worth our time to give them a relatable metaphor and listen to them repeat back their understanding of the concept. Then when we don’t have an evidence-based answer, let’s just be honest: All we can do is stick with them to search for answers together.
6. Make it easy for patients to do what we want them to do. We want them to take their meds, so getting a refill should be easy. If we want them to get diabetes education, then let’s prescribe online videos with a quiz at the end instead of asking them to take off work to attend a class during business hours.
7. Recognize the patient’s experience. They’ve dealt with their own bodies a lot longer than we’ve studied them, so we need to pay attention to the clues they share. We should write them down and watch for those details to come together to solve clinical puzzles. These mysteries are one of the thrills of medicine and it is the secret to avoiding a misdiagnosis.
8. Let patients speak for themselves. In the exam room, that means we should ask the patient to prioritize their list of problems when we believe we can’t address them all in one visit. We should not impose our own priorities, or allow a third-party representative to impose theirs, because the patient doesn’t want to come back tomorrow to address today’s chief complaint. So talk about their bunions today, and then maybe they’ll come back to discuss their labs.
9. Question the logic of ordering a lifelong treatment for temporary discomfort. We really need to mention if going off that drug will kill the patient before they start taking it to cosmetically improve the redness under their toenails. Give them a chance to understand the plan and opt-out or refuse. A lot of people would rather get a root canal than start a new prescription or have surgery again.
10. Don’t assume that patients want cheap care. Patients want to make decisions about where to spend their money, but that doesn’t mean they want to buy healthcare that will break when they use it.

What do you think? Is there something you think is vital to patient-centered care yet often overlooked?