It is said that “turn around is fair play.”

So if providers (physicians, hospitals and other health care professionals) expect patients to become more engaged in their own care, isn’t it fair for patients to expect their physicians to also get more involved in their care?

If you look closely at “proxy measures” for physician engagement, you will see that this is a legitimate if not equally important line of inquiry.

Hello? Hello? Anyone there?

Take “listening” as a proxy for physician engagement.  The importance listening was underscored back in the 1880’s by of Sir William Osler, the founder of modern medicine, who said “listen to the patient they will tell you what’s wrong.”   Listening to patients was and continues to be a challenge for providers.   Research shows that on average, physician interrupt our (remember we are patients sometimes too) opening statements within 18 seconds.  This is significant since the “opening statement” is where we are telling the doctor the reasons for our visit.   Not surprisingly, being a “poor listener” is a chief complaint patients have about their physicians.

How do you feel when a friend, a colleague, or your spouse interrupts you when you are trying to make a point?

Ignoring certain patient “cues” is another proxy for physician engagement.  Depression is a great example of an entire category of topics, e.g., psycho-social issues, systematically ignored by many physicians.  Opening the Pandora’s Box of depression, anxiety, etc. can take a lot of time and push the physicians’ skills limits, but patients who bring it up are suffering and want to be heard.

How would you feel if you were obviously bleeding from a wound and your best friend was too busy to bandage your bleeding wound?

Telling patients to do something that they are philosophically against is yet another proxy measure of physician engagement.   A lot of patients for example don’t believe in taking RX medications as the first course of treatment.  Yet a lot of patients feel that is exactly what happens.  Physicians, due to a lack of time or a belief that patients are inherently adverse to life style change, prescribe an medication for high cholesterol, high BP, etc. as the first course of treatment.

How likely are you to fill a prescription that you didn’t ask for and don’t want?

Yes, physicians are too busy … yes physicians are not reimbursed enough.  But you can say the equivalent for us patients – we are not listened to, we are objectified as a disease, and we are not understood or respected as a person.

You get the point.  Engagement is a two-way street.  If physicians and hospitals want patients to become more engaged then they are going to have to become more engaged.   Engagement, like so many social behaviors, is reciprocal.   So, how are you measuring physician engagement in your organization?

Steve Wilkins is a former hospital executive and consumer health behavior researcher who blogs at Mind The Gap.

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