Patient-Provider Dialogue: Your Brand Depends On It

The most important conversation a patient has is with his or her provider. And when gaps occur in the treatment discussion, your brand may be missing an opportunity to reach its full potential. To fully recognize the gaps and opportunities regarding patient-provider dialogue, let’s look at the conversation from the perspective of both, the patient and provider.

I’m fine. Really.

For a moment, consider you’re a patient with a chronic disease. Every day you make decisions (maybe hundreds of them) regarding your health. Decisions about what to eat or whether or not to exercise, how to manage your symptoms, how often you take your medicine, or whether you take it at all. Decisions weighing medication cost and side effects against symptom control. Decisions to put your daughter’s health ahead of your own.

Now imagine sitting in an exam room during a routine doctor appointment. You are tired but not in pain. Remarkably, this day has been a good one, considering the succession of bad days you’ve recently had. You like your doctor and want her to be proud of how you’re doing. So when she asks, you simply respond with, “I’m fine.” You tell yourself that you just need to get through the labs and then the stress will be over. Your labs are good. Check. Your doctor says that everything looks good. Check. She refills your prescription. Check.

Could my symptoms be improved? My treatment seems to be working. Just stick with it. Besides, my labs are good. She said so herself. These are thoughts that cross your mind, but are not concerns you bring up.

Keep up the good work.

Now, let’s switch places. You are the provider. You notice the smile on your patient’s face. His color looks good and he’s cleaned up. You laugh at his funny remark, and think to yourself: That’s good. He’s feeling well enough to take care of himself and to laugh. You ask how his work is going, and he admits he missed a few days during the last couple of weeks.

Even though his labs are satisfactory, you are seeing a trend. That, coupled with his days off work, has you a little concerned. Is it the beginning of another decline? When you ask about his daughter, his face changes. You don’t pry, but you can tell she’s not doing well—that means he has even more on his plate. There’s an opportunity for you to be more aggressive with his treatment, but is it the right time? Could he handle it? Maybe it’s better to not overload him with a new treatment. You decide you will talk to him about a more aggressive approach at his next appointment. Your nurse interrupts and says there’s a situation across the hall that needs your attention. You shake his hand, tell him you want to see him again next month, and encourage him to keep up the good work.

What’s the impact?

In this situation, your brand doesn’t even make it into the conversation. The patient and the provider make assumptions, they speak politely and they move on to the next task in their respective day. Your brand’s outstanding efficacy data doesn’t enter the provider’s mind. And the patient doesn’t even know that “better” is possible.

Ambivalence, overwhelmed, unclear. These words don’t just describe the patient. The provider often navigates the complexities and lack of precision that permeates our healthcare system. Patients and providers lean on their assumptions to make decisions. Those assumptions don’t always lead to optimal patient outcomes.

Why Patient-Provider Dialogue Matters

Behaviorists have studied dialogue for decades. Thousands of studies examine patient-provider communication and interventions that impact dialogue. Here’s what the research reveals:

Dialogue Impacts Outcomes: Patient-provider communication impacts both short- and long-term outcomes. Research demonstrates that poor communication leads to distress, uncertainty, internal conflict about decisions, dissatisfaction, and treatment nonadherence.1 And these are outcomes that brands should care about.

Evidence-based techniques can help bridge the gap to effective communication: Communication is something that can be learned and changed. Evidence-based communication techniques, including Motivational Interviewing, Health Coaching, and Shared-decision Making are practical and can be applied digitally, via phone, or in person. These techniques have been proven to be effective, even in a highly regulated pharma environment.

Studies show when these techniques are utilized, patients leave conversations with more knowledge and a better understanding of their personal risk. When patients have a voice and become aligned with their treatment decisions, there’s greater satisfaction with therapy and ultimately with, greater adherence.2

Providers are clinical experts, not communication experts: Effective communication is not just about having a good bedside manner, it’s a skill. Most providers are not trained in patient-centered or evidence-based communication. Research shows that providers often overestimate their communication abilities. For example, in a study examining patient conversations between orthopedic specialists and their patients, 75% of physicians believed they communicated in a satisfactory way. However, only 21% of patients agreed.3

How can your brand optimize patient-provider dialogue?

Consider this roadmap to address patient-provider communication challenges.

  • Construct an evidence-based story. To drive internal support, leverage behavioral science to craft a story that demonstrates how addressing dialogue can accelerate your commercial outcomes.
  • Create a strategy that addresses both patients and providers. Take a look at your brand plan, work with your patient and provider marketing teams, and find opportunities where dialogue solutions can be used to generate the greatest influence.
  • Design your program to do more than build knowledge. Are you relying on information-based and awareness approaches to change dialogue? If so, you will have limited success. Information-based approaches are largely ineffective in changing behavior. Instead use evidence-based strategies from behavioral science to build skills and change communication behaviors.

Improved dialogue can help you accomplish brand objectives, increase patient satisfaction, deliver greater value to customers, and facilitate better patient outcomes. Patient-provider communication is a critical part of your brand’s success. Shouldn’t you give it the attention it deserves?

References

1. Lee EO, Emanuel EJ. “Shared Decision Making to Improve Care and Reduce Costs.” N Engl J Med. 2013;368(1):6-8.

2. Epstein RM, Alper BS, Quill TE. “Communicating Evidence for Participatory Decision Making.” JAMA. 2004;291(19):2359-2366.

3. Tongue JR, Epps HR, Forese LL. “Communication Skills for Patient Centered Care: Research-based, Easily Learned Techniques for Medical Interviews that Benefit Orthopaedic Surgeons and Their Patients.” J Bone Joint Surg Am. 2005;87:652-658.

  • Jessica Brueggeman

    Jessica Brueggeman is SVP, Health Behavior Group at MicroMass Communications, Inc. Jessica leads a team of behaviorists in applying behavior change strategies to health communication programs. Recently, her role expanded to include development of new products and services for health systems and ACOs.

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