June 17, 2015 — Blog Post
Buying In: Shared Decision Making with Chronic Condition Treatment
Chronic health conditions can be difficult to manage on both the provider and the patient side. It depends a great deal on having the patient “buy into” the treatment – and really, even the diagnosis. So how do you do that?
The patient buy-in
One way is for a provider to explain how and why this diagnosis seems accurate to them, citing information the patient has presented them (and perhaps other information from other clinicians). This already lends authority in the patient’s mind since they were the very ones who provided the basis for the diagnosis.
The clinician might further say to the patient “Does that sound right to you?” or “Am I understanding what you’ve told me, correctly?” This gives the patient some authority to speak up and say “No, you misunderstood when I said XYZ. What I meant was ABC.” Or they can agree and feel as though their clinician is listening to them.
Buy-in with treatment
When it comes to treatment, most of the time, treatment is managed at home by the patient. It’s especially important, then, that the patient brings up any barriers to compliance so the clinician can address them or adjust the treatment. Here, an example might be to say, “Medication X could work very well for you. It’s best taken four times a day. Is that something you could work into your schedule?” Again, this allows the patient to speak up if that seems burdensome, or if the timing doesn’t work.
The clinician might then follow up with another question like “Do you have any hesitations around this medication?” allowing the patient to bring up any other barriers, like cost or side effects that they might not otherwise feel comfortable mentioning. While it may seem like prying to some, the additional question can really open up the floor and authorize the patient to express any concerns they might feel aren’t “important” but which may affect their compliance at home.
Using these techniques
Many clinicians already utilize shared decision making language and questioning in their daily clinics and visits. But considering the patient as someone who needs to “buy into” the treatment and diagnosis may be a helpful way to keep shared decision making front and center in each interaction, both for those who already employ it, as well as for those for whom it’s new. And in the long-run, it may cut down on non-compliance issues and allow for better conversations on both sides of the encounter.
How do you address getting patients on board in your practice?