Engaging Patients: Appeal To The Elephant

I am in the middle of reading a book called Switch.  It’s a very compelling book about some clear things you can do to make change happen when it seems hard.  The authors elegantly outline some strategies that seem very doable, and can apply to both personal changes to organizational changes. 

Imagine a person riding an elephant along a path.  The concepts in Switch revolve around three aspects of change:  “The Rider,” “The Elephant” and “The Path.”  The rider is a person’s rational self, the elephant is a person’s emotional self, and the path is the environment.  The rider is smart and tries direct the elephant where to go, but the elephant is big, unwieldy and takes a lot of energy to get going.  But don’t underestimate the landscape:  If the rider and elephant are going full-blast, in a landscape of quick sand, you’ve got serious problems.  For many Big Changes, you likely need to address all three. 

One question I keep hearing about the medical home is – Yes, we can do all these wonderful things in our practice but how can we make the patient value them?  What I’m hearing in this question is really two questions:  1) How can we inspire the patient to value their health more and 2) How can we inspire them to value our array of services more? 

I believe that engaging patients in the medical home needs to hit the rider, the elephant and the path.  For the rider, that means explaining what medical home is, why it is important, and what an individual practice is doing to become a medical home:  the brainy stuff.  For the path, that involves some new ways of interacting – like care teams, or a patient portal.  But I believe elephant will pack the real punch with engaging patients in their health and healthcare.

I recently had a very ‘elephant’ experience with my primary care provider.  They never used the words ‘medical home’ and they could certainly beef up their 'medical home-ness' but because of what happened, I plan to always see that team for my care.  I had bronchitis that just would not go away.  At one point, on my 2^nd round of antibiotics, my doctor actually called me at home to see if I was feeling better!  Later, I had to have a test and she asked that I call and speak with her directly to get the results.  I am not sure I’ve ever had a doctor express to me they actually cared about me as a person the way this doctor did.  It hit me right in my elephant.

The rider and path are crucial, but that big ol’ elephant needs to move.  Making patients feel like they have a provider/team who knows and truly cares about them will be the core of any desirable changes at the patient level.