Dr. Nora Zetsche | May 17, 2018
 


Veta Health Co-founder, Dr. Nora Zetsche, discusses her experience practicing medicine and how advances in the field are enabling positive changes in care delivery. She touches on the benefits in shifting towards care models that encourage patient self-management and how technology can further enable providers and their teams to confidently make this switch and see significant improvement in their patients at the individual and population levels. 


 

 
From the time we are children and learning to say the word “no,” most people don’t respond well to being told what to do. There’s a spirit within us of wanting to be in control of our own decision-making, in control of our own lives.
 
Given that, it’s no wonder so many patients have a hard time listening to their doctor. Most doctors—myself included—were trained in a very paternalistic model of care. We are the experts who know what’s best for our patients, we tell our patients what to do in order to feel better, and then we send them on their way and hope for the best.
 
In cases where treatment is straightforward and simple, this usually works fine; the patient takes a couple of pills and they’re good to go. But in instances of chronic conditions or complex treatment plans involving things like lifestyle changes, this model often fails. Patients either do not understand the treatment well enough to implement it once they leave the doctor’s office, or are not bought into the decision enough to actually do it. Think about the diabetic patient who seems to refuse to change their diet; think about the patient who you tell to stop smoking and then find smoking in the courtyard outside of your office right after an appointment.
 
The good news is, there’s a new model of care in town: patient self-management. This approach sees doctor’s visits as more of a collaborative conversation than a place to deliver directives. It acknowledges that so much of a patient’s treatment happens outside of the doctors office, and makes sure patients feel supported in making that happen. It emphasizes the fact that patients are the #1 decision-makers in their own care—making it much less likely for them to rebel against the plan that will help them get better.
 
The change is already happening—and technology is making it even easier—but we still have a ways to go before patient self-management is the new norm. Here are a few reasons why I’m truly excited to see this change on the horizon, and encourage you to look for ways to integrate patient self-management into your practice.
 
You Can’t Be There All the Time
The time a patient spends with a practitioner in an office or hospital is often a tiny percentage of their entire care journey. As soon as a patient walks out the door, it is up to them to implement the recommendations you’ve suggested. So, in essence, patients already play a huge part in self-managing their own care—it’s more a question of whether they’re able to do it well.
By embracing patient self-management, doctors have the opportunity to proactively provide their patients with the resources necessary to ensure successful care outside of the office. Technology makes it easier than ever for doctors to collaborate with patients—why not use these capabilities to offer curated content that will help a patient get better, even when you’re not around?
 
You Don’t Know Everything Going on in a Patient’s Life
Undoubtedly, the doctor is the expert when it comes to disease—if every patient tried to self-diagnose and treat using Dr. Google, we’d all be in trouble. But the self-management model acknowledges an important fact: that the patient is the expert of their own lives.
So, while you may know the best treatment plan medically speaking, you may not have a good sense of how feasible it will be for the patient to implement it given the realities of their lives.
In patient self-management, the focus shifts to educating the patient about their disease and the options that they have, but more power is in their hands to decide what course of treatment they want to pursue, allowing them to take into account what feels possible in their lives.
 
You Can’t Motivate a Patient on Your Own
You can only do so much for a patient if they aren’t willing to help themselves. I truly believe so much of successful medical care is in the mind, and if the patient doesn’t believe they can follow a treatment plan or doesn’t think it’s going to work, then they’re probably right.
This goes back to that idea of driving our own decisions. If the patient feels like they’re just following orders from you, they might feel less invested in actually doing it (or worse, feel rebellious against it). But if they’ve played an active part in determining their treatment plan, suddenly the motivation is coming from within.
The self-management model is all about improving a patient’s sense of self-efficacy—showing them that they are capable of taking care of themselves. By improving their confidence in themselves, you start to improve their confidence that they will be able to get better.
Convinced yet? If you’re curious about self-management and aren’t sure where to start, or just want to learn more, request a demo of the Veta Health platform on our homepage.