Recently, Healthassist Healthcare Advisor, Anne Jacoby, began working with a new client. As part of our standard process, she began by conducting a thorough evaluation. Both the client (Jake) and his wife (Elizabeth) were present as Anne asked about Jake’s medical conditions and the medications he takes to help them.
She also asked Jake to describe all the members of his healthcare team, including his primary care physician as well as any specialists he sees. Jake has a progressive neurological condition and, like most of our clients, a complicated medical history. He sees numerous specialists, one of whom addresses his movement disorder. Because he sees many specialists, care from each of them needs to be coordinated.
Jake and Elizabeth described the relationship they have with Jake’s neurologist; it was obvious to Anne that their feelings were mixed. Jake said it was “okay enough.” Elizabeth was not fond of the doctor and complained that he never gave them the amount of time they needed during appointments to discuss all the items that were on their minds.
Preparation is the key to communication success
Each of our new client evaluations ends with the establishment of a project plan and a list of priorities. Anne proposed the topic of, “Improving your relationship with your neurologist,” as one area of focus. Jake was intrigued by her suggestion (although not optimistic!); he wanted to know what he could do to make this happen.
The approach was two-pronged: To obtain all the information needed (during the interview process, Anne discovered some gaps) and to improve communication with the neurologist. As is usually the case, they began with the creation of a comprehensive agenda that could be shared with the physician at the beginning of the next appointment. Specifically, Anne suggested that they:
- Gather all medical records related to the treatment of Jake’s neurologic condition. This required making formal requests, in writing, according to the health system protocol documented on the “Requesting Medical Records” page of the health system web site. Sometimes these requests can be faxed, mailed, or delivered in person. Jake decided to deliver his request in person so that he knew it was received.
- Obtain diagnostic test results for recent CT Scans, MRIs and neuro-psych testing. There had been many of these over the last few years, some of which had taken place outside of Jake’s current health system. So additional medical record request protocols were researched and followed.
- Enroll in patient portals. Jake received care from two different health systems, both of which offered online patient access. One-time enrollment in these allowed Jake and Elizabeth to continue gathering information as well as communicate easily via secure email with the physicians involved.
- Prepare a comprehensive list of all medical conditions, medications and providers. This included everything, both inside and outside of the health system in which Jake’s neurologist practiced. The goal was to establish a comprehensive sharing of information among Jake, Elizabeth, and all physicians involved, to ensure the coordination of efforts and prevention of duplication.
- Create a comprehensive written agenda for the meeting. This included a meeting objective, as well as topics for discussion and specific questions that Jake and Elizabeth wanted answered. [For more information regarding agenda preparation, please see our earlier newsletter: 3 Suggestions for Using a Written Agenda to Improve Your Next Physician Meeting.]
- Practice. Anne worked with the couple to help Jake get comfortable talking with the doctor and Elizabeth get comfortable fulfilling the role of scribe. In particular, they practiced how the agenda item of, “Our relationship / communication with you, my neurologist,” would be addressed.
An often overlooked aspect of successful medical care is the importance of the patient/physician relationship. Happily, and with some preparation and coaching, many individuals are able to establish a comfortable and effective flow of communication with the various members of their medical team.
Do these steps always work to improve the patient/physician relationship? No. In fact, and despite doing a wonderful job following the steps outlined above, Jake and Elizabeth eventually decided that a change was needed and went off to find a different neurologist for Jake (the subject of next month’s newsletter!).