Chapter 17: Information therapy - how to educate your patients
|"Information is the best prescription."
- Dr Koop.
The commonest complaint patients have about their doctors is that they never explain what is happening. It is true that doctors no longer spend enough time talking to their patients, and this leads to a further widening of the doctor – patient communication gap. You need to share information with your patients and educate them about their problem, so that they can make informed decisions for themselves.
Today patients are aware of their rights. This has had its effect on medical practice as well - especially in the U.S.A, where it is mandatory to inform and educate the patients about their choices. With the introduction of the Internet, medical and health information has become much more easily available to the lay person in India. Today, the intelligent patient can do free Medline searches sitting at home, and explore advanced treatment options available at the worlds best medical centers. Patients are going to start demanding information , and rather than see this is a problem, its actually an opportunity for you to promote your practise. Smart doctors are proactive , and by providing this information freely on your own, you can become a leading expert in your field.
Remember that educating your patient is in everyones best interests, including yours. Patient education is important as a practice promoter - patients appreciate your taking the time and effort to inform them. This helps you to stand out from the other doctors he may have visited, so that when he finally decides which surgeon to select, he will be more likely to pick you.
It is well known that patients forget over half of what the doctor tells them because of the stress of the consultation. Giving them printed materials to read at home will help them to remember. This will help to prevent midnight calls about unimportant issues - and ensure peaceful nights for both patient, and doctor, because the patient will not need to trouble you about trifles. Printed educational materials also help to increase patient compliance and the printed word is useful in reinforcing your advice and instructions. It helps to educate the rest of the family as to what is happening - and this is important in India, where it is often the family, which makes decisions regarding medical treatment.
Doctors learn a lot from the intelligent patient. After all, physicians are not veterinarians and the inquiring and well-informed patient can teach you much more about medicine than any textbook. A patients questions will make you think about things you may otherwise have taken for granted. Also, reading patient educational literature can teach doctors to look at things from the patients point of view. This helps to increase your empathy - a very desirable goal. Your patients may also help to make you aware of advances which are occurring in other parts of the world - which you may otherwise have overlooked.
Some doctors feel threatened by a patients questions - and may feel that the patient is challenging them by asking questions. This is not the right perspective at all. Remember that both doctor and patient have a similar goal - to make the patient better - and questions should be encouraged and answered, rather than leaving doubts to fester - a situation, which can create unnecessary problems later.
Patient education is likely to reduce the risk of inadvertent complications. After all, we are all human, and may make errors - for example, prescribing drugs which may have an unwanted interaction. Intelligent patients are highly motivated to look after themselves and the informed patient can sometimes point out possible problems with your treatment plan which you may have overlooked (for example, a patient with G6PD deficiency should know which drugs are unsafe for him).
Educating patients will help to prevent health fraud and quackery in the community. This is especially true for chronic illnesses (such as arthritis), and medical problems for which we do not as yet have effective solution (such as cerebral palsy). If you teach your patient about what can be done to help him, as well as the limits of what medicine can offer him, he is unlikely to be cheated by quacks.
It is important to document that you have informed the patient of possible complications and risks - and educational handouts offer proof in black and white that you have done so. Taking "informed consent" is important, but for most doctors it simply means taking the patients signature on a standard form - more as a medico - legal formality, without really "informing" the patient about anything. Patient education is an integral part of" risk management" in medical practice today, and will reduce the risk of your being sued if complications do occur.
There is some-thing special about the printed word. Patients who are anxious about their health will seek more information on their illness – and doctors have only a limited time in which to answer all their queries. Rather than force patients to turn to unreliable sources of information (e.g. the Internet , or sensationalized media reports), because these are readily available, doctors need to intelligently use a variety of printed materials to both educate existing patients , and to attract new patients to their practices. I first realized what a wonderful service this was to patients when I was a medical student at the Johns Hopkins Hospital .
The reception area was filled with brochures, newsletters, and fliers that covered a plethora of diagnoses. The materials were all professionally produced and the information was easy to read. A patient who is anxiously waiting to see the doctor might pick up one of the brochures - and have more confidence that the doctor he was about to entrust his health with was indeed an expert in his particular condition. Most successful physicians have all developed unique ways of communicating with patients – and written materials are extremely valuable.
Brochures are generally inexpensive printed materials that can be read at a glance. They can be effectively used to educate patients. For instance, in our practice, we routinely perform a number of procedures including laparoscopy and hysteroscopy. We use brochures to educate patients about these procedures. Once they have read the appropriate brochure, I review the risks and benefits of the proposed treatment. These brochures expedite the consent process and give patients something to take home in case a family member has questions. In my experience, patients are often relieved to read the brochure, because it signifies that although this is a new procedure to them, I have done lots of them. A brochure helps establish my credibility and experience with a proposed procedure , and at the same time educates the patient.
Effective brochures are easy to read in a short period of time. Brochures in the waiting room can alleviate patients fears and anxieties before their scheduled appointments. Brochures also offer the opportunity to present references and to provide details about your training and credentials. It is now possible to buy pre-printed brochures from medical societies, and a number of commercial publishers in the USA and UK. Many Indian medical associations and pharmaceutical companies have also started publishing these. The benefit of these is that they are often very well designed, attractive and have reliable content; however, they may not be customized to your own practice and philosophy.
This is why many doctors prefer to produce their own custom brochures. Desktop publishing makes it easy to create brochures for a fraction of the cost of having them designed and produced by a professional. However, marketing experts are loath to
recommend this route, because poorly designed brochures may produce exactly the opposite effect from what you want. Poorly designed materials can damage your image and may discourage patients from seeking your care, so it may be worthwhile to hire a
professional to design and produce your personalized brochures. As with all printed materials, both the content and presentation of the brochure are critical.
Some common mistakes that will sabotage your brochure include : using too much running text and not enough bulleted information, using too many big words or complicated medical terms, and forgetting to put in contact information.
Its worth using commercially published brochures as models, and copying them when
starting to publish your own. Try to have a consistent design and logo, so your patients can easily identify the printed educational materials you produce. A simple inexpensive trick is to use the same background light colour (for example, lilac), for all your brochures.
If you get more ambitious, you can also decide to publish a newsletter on a regular basis, to help update your patients about the recent advances in your specialty ; and also inform them about the new services you offer. Many doctors find that this is a very cost-effective way of marketing as well, because patients will often pass on a newsletter which contains educational material about health to their friends and relatives – all of whom are potential new patients for your practice . And dont forget that in this digital age a website can be very effective in educating your patients without having to cut down a single tree !
A common question doctors ask is: isnt this is a hassle? Who has the time to sit and teach patients? However, just like you prescribe drugs, it important to prescribe information as well ! It is important that you then discuss the results of this information search with the patient, so that you can help him to determine which information is relevant to his particular problem. Remember that patient education is a worthwhile investment of your time - after all, the best patient is a well-informed one. You must aim to empower your patients , by providing them with the information they need to promote their health, and prevent and treat their medical problems in partnership with you - their doctor.