09 October 2013

Communications By Any Other Name - Worthless

You may wish to skip this blog. This is because I am overly critical of another blogger. I normally respect this blogger and she has much good to say, but that was not my take on this blog.

Again, I wonder why is it that doctors misunderstand communications. Every doctor has his/her interpretation of patient engagement. Now I will add the term “meaningful use” to patient engagement and say that most doctors are trying to hide behind the two phrases and are not concerned about communications with the patient. To quote Dr. Rob Lamberts, “Communication isn’t important to health care, communication is health care. Care is not a static thing, it is the transaction of ideas. The patient tells me what is going on, I listen, I share my thoughts with the patient (and other providers), and the patient uses the result of this transaction for their own benefit.”

I respect the definition by Dr. Lamberts, but anything in other definitions is bull, and the quicker we as patients understand this, the better off we will be. I covered his blog that Dr. Leslie Kernisan refers to, but do not understand why she had to muddy the waters even more. I will quote Dr. Kernisan to show this: “Here’s my current take:  Supporting patient engagement means fostering a fruitful collaboration in which patients and clinicians work together to help the patient progress towards mutually agreed-upon health goals.” Mutually agreed-upon health goals may not always be in the best interest of the patient.

She says everything but communication as if communication is a term to be avoided at all costs. Then she uses the term to bring people back to patient engagement. I quote, “Communication with patients is, of course, essential to all of this. This is why any innovation that improves a patient’s ability to access and communicate with healthcare providers is proudly labeled as “patient engagement.””

Remember meaningful use, doctors may not meet this if they use communication instead of meaningful use. Then we find out that Dr. Kernisan prefers to quantify patient engagement when she states, “Back to the examples of patient engagement cited above. What are the “right metrics around what constitutes real patient engagement”? Obviously, it will be difficult to agree on metrics if we don’t first agree on the definition.”

Sounds to me she is trying to calculate how to fit this into meaningful use. Tell me this isn't so, doctor! I am even more concerned now and have to wonder what it is about the word communications that doctors are unwilling to accept this, with the exception of Dr. Lamberts.

I become very uncomfortable when doctors use the term patient engagement around me and even more when they use the term in surveys sent out to attempt to get praise for their actions. I refuse to return these and when one doctor called me to find out why I had not returned the survey, I am afraid I was not too polite in my response. I also said that the phrase patient engagement had no standard meaning and communication was definitely not part of my appointment other than keeping my mouth closed except to answer questions.

Of course, the doctor disagreed. I asked him who had set the goals I was to use for my health. When he said we both had, I reminded him that I had not indicated I approved or disapproved of the goals he had laid out. I then told him where I disagreed and why. He quickly asked me to complete the survey and return it. I said I would and I would send one to the administrator and keep another copy for my records. “Click” was the next sound and it was more of a “bang.”

I did return the survey, but he is no longer a doctor on my team and that is by mutual agreement.

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