Patient Engagement
Clip
The Physician’s Role in Improving Patient Behavior (05:28)

What’s the role of clinicians, particularly physicians, in steering patients toward behavior change? Should they be cut out of the loop? Or is there potential synergy with the patient?

“The clinician plays a vital role and probably an increasingly vital role the more complicated and dire the health circumstances are,” says Katherine Baicker. If a patient needs bypass surgery, for example, they can’t determine the best type of procedure and where to go for that procedure and rehabilitation on their own. She adds that health reforms are empowering physicians to play more of an active role in patient steering, and that patient incentives and physician incentives can work hand-in-hand to promote good steerage through the health care system.

After all, physicians are subject to the same behavioral biases that patients are when it comes to making decisions, Baicker says. “The variation across physicians tells us that there are some things that some people are doing really well that maybe could be adopted by other people,” she explains, “and learning what those techniques are beyond the walls of the health care system, I think is one of the most promising avenues for harnessing those social determinants, and the physician is in a good position to do that.”

“I think we’ve never needed physicians more,” says David Asch. “People trust physicians, and trust is an incredible social lubricant that reduces the transaction costs.” Messaging from an insurance company or employer might leave a patient cynical, but when that same message comes from a doctor, its meaning changes. “We can develop perhaps the right message, whether that is an educational message or a behavioral approach, but the messenger is incredibly important in that,” says Asch, emphasizing how important it is for patients to harness their existing trust relationship with physicians and nurses for optimal benefit.

Niteesh Choudhry makes the distinction between diagnosis and treatment recommendation, and treatment delivery. Just because the physician is a “trusted lubricant of the delivery of what needs to be done” doesn’t mean that they need to be the deliverer of it, he says, adding that sometimes physicians do a “particularly bad job.” If someone who comes to an appointment has poorly controlled diabetes, for example, the result might be the physician delegating the tasks by sending that patient to a number of specialists. “Taking us out of the loop is probably not the right answer,” says Choudhry, “but also relying on us to do all of these things is probably not the answer either.”

From the NEJM Catalyst event Patient Engagement: Behavioral Strategies for Better Health at the University of Pennsylvania, February 25, 2016.

More From Patient Engagement
Many Barriers to Engaging Patients in Treatment for Obesity

Survey Snapshot: Approaches to Address Clinician and Societal Roles in Obesity

The obesity problem is getting larger and larger. Some solutions lie beyond the traditional medical setting.

Esch01_pullquote patient activation

OpenNotes, Patient Narratives, and Their Transformative Effects on Patient-Centered Care

The development of standardized tools and techniques are enhancing the ability of providers to interact with patients, but true patient engagement requires a common understanding of its theoretical foundation and an open mind for including patients’ needs and beliefs — in their language — as part of each encounter.

Patients and PCPs Hold Primary Responsibility for Addressing Obesity

Patient Engagement Survey: The Failure of Obesity Efforts and the Collective Nature of Solutions

Patients hold responsibility for their actions, but providers’ approaches to address obesity often fall short as well.

Items from the Shared Decision-Making Process Survey for Elective Surgical Procedures - patient decision aids - decision quality - informed consent

Shared Decision-Making: Staying Focused on the Ultimate Goal

Despite growing acceptance and enthusiasm for patient involvement in their health care decisions, clinicians, at times, lose focus on the ultimate goal of shared decision-making: better health decisions from the informed patient’s perspective.

Kangovi01_pullquote community health workers boom

The Community Health Worker Boom

Practical insights that can help organizations optimize their investments in community health workers.

MD Anderson Cancer Center PAAC Health Information Data Before and After Implementation of New EHR System

Using a New EHR System to Increase Patient Engagement, Improve Efficiency, and Decrease Cost

The University of Texas MD Anderson Cancer Center saw active participation from patients by encouraging them to document their own health information into a new EHR.

Phrases That Enhance Physician-Patient Communication for Scripps Health Hospitalist Groups

Improving Hospitalist Patient Experience Scores: The Importance of Physician-to-Physician Coaching and Medical Director Engagement

With the Centers for Medicare and Medicaid Services incorporating patient experience into Value-Based Purchasing metrics, hospital leaders must focus on improving this important aspect of patient care.

DLewis01_pullquote Opening Up to Patient Innovations Like Automated Insulin Delivery

Opening Up to Patient Innovation

Next-gen innovations — by new stakeholders — will need a next-gen regulatory system, and clinicians willing to adapt.

Karen DeSalvo - public health population health social determinants of health expert social services infrastructure

Moving from a Sickness Model of Health Care to One of Well-Being — Part 2

A public health expert discusses the scientific, technological, and financial foundations needed to modernize the social services infrastructure and address social determinants of health.

PROs Associated with Better Top-Box Satisfaction Scores at UPMC

Better Physician Ratings from Discussing PROs with Patients

A UPMC study demonstrates the value of PROs, but finds that physicians need to discuss that information with patients during visits.

Connect

A weekly email newsletter featuring the latest actionable ideas and practical innovations from NEJM Catalyst.

Learn More »

Topics

OpenNotes, Patient Narratives, and Their Transformative…

The development of standardized tools and techniques are enhancing the ability of providers to interact…

Care Redesign Survey: Lessons Learned from…

Although care delivery models in rural and urban/suburban areas are distinct, by virtue of geographic…

Care Redesign Survey: Lessons Learned from…

Although care delivery models in rural and urban/suburban areas are distinct, by virtue of geographic…

Insights Council

Have a voice. Join other health care leaders effecting change, shaping tomorrow.

Apply Now