Treatment adherence has always been an important consideration for clinicians, but it takes on a new dimension when reimbursement depends on outcomes as well as services rendered. Because many patients must navigate complicated treatment regimens that may include medication, lifestyle changes, and self-monitoring, maintaining adherence is more challenging—and more important—than ever.
Better communication may hold the key. By starting a dialogue and using proven communication techniques, clinicians can work with patients to develop a treatment plan with which the patient feels comfortable and that can possibly lead to increased adherence and better outcomes.
Improved communication can also result in greater patient satisfaction, fewer follow-up questions and visits, and a lower risk of malpractice lawsuits, says Cecile Carson, MD, senior trainer for the Institute for Healthcare Communication. Patients are more likely to follow a treatment recommendation when they believe in its importance, Carson explains. Sharpening the following “bedrock interaction skills” can make all the difference.
Invite a Narrative With Open-Ended Questions
Yes-or-no questions typically elicit 1-word responses that rarely get to the heart of the matter. To gain a deeper understanding, clinicians should hear the reasons and context for the patient’s behavior or decision-making process.
Respond With Reflective Listening
Show that you’ve heard patients’ concerns by repeating back what they’ve said.
Follow-up questions can reveal the roots of resistance. For example, a patient’s refusal of chemotherapy may be based on a family member’s experience that isn’t relevant to the recommended treatment.
Roll With Resistance
It isn’t helpful to keep hounding a patient who can’t or won’t comply with the recommended treatment. Pushing only invites push back, says Carson. Physicians often look at decisions as “all or none,” but often there’s a middle ground.
Recognize That Change Is a Process
People don’t change their minds overnight, let alone in a 15-minute appointment. Sometimes just persuading the patient to think about change is enough progress for 1 visit.
Clinicians should also explore their own beliefs about their role as healers and their ability to effect change. “If I don’t see my role as a change agent, then I can’t engage meaningfully with patients,” Carson explains.