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As any busy dermatologist will tell you, good medical assistants (MAs) are worth their weight in gold. Wait, make that platinum - good medical assistants are really valuable. Who else has the power to make your day run flawlessly, calm restless patients when you're an hour behind schedule, and take care of the myriad details that would bog you down in a hurry if you had to tend to them all?

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Using the Fourth Exam Room (Part 5 of 12)

Thursday, December 15, 2005

Many physicians bog down their workflow by batching a lot of work for the end of the day. When it's finally time to go home, there are charts to dictate, calls to make, and so on. Why not dictate, instead, while you are with the patient?

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Practice Management

Improving Education: Engaging Patients in Care for Optimal Results

Karen Childress

Tuesday, November 08, 2005

Clearly, patients who understand their medical conditions will be more likely to follow through with the dermatologist's recommended course of treatment, ideally resulting in better clinical outcomes. Educating patients takes time, but there are a variety of ways to streamline the process.

Understanding how motivated patients are to learn and partner with you in their care will, in part, determine how you communicate with and educate them. A teenager with acne who begged his mother to bring him to see you will respond more enthusiastically than a teen who was dragged to your office against her will. In the first instance, speaking directly to the young patient - explaining carefully what causes acne, the various treatment options available, and what he should expect in terms of results - will most likely be successful. With a less motivated individual, direct your comments to both patient and parent in hopes that the parent will work with the teen at home to follow the prescribed regimen.

Communication basics

Gerald Goldberg, MD, of Pima Dermatology in Tucson, Arizona, believes patient education requires a multipronged approach. "No one thing works for everyone. Some people want face-to-face time [with me] explaining a body condition or disease … others want to know more about treatment options or side effects," he says.

Meet patients where they are in terms of their level of interest and sophistication about health issues. Understanding how patients absorb data and follow instructions comes with experience, intuition, and keen observation skills. "You have to be alert to nonverbal cues about how or if they're receiving the message. If [patients] seem puzzled," says Goldberg, "go over it again."

"Reinforce what you say verbally with printed materials," Goldberg continues. "My medical assistant [completely writes out] the treatment plan: clean with this, put this on, then sunscreen. It's spelled out on a sheet and handed to the patient. [For] anything that is at all complicated or when the patient is elderly or a teenager … we give them something in writing."

Get staff involved

At Pima Dermatology, staff are actively involved with patient education. While Goldberg conducts the patient interview and examination, his medical assistant listens closely and gathers the appropriate printed materials to reinforce his message. "The staff will sit down with a patient after I leave [the room]," says Goldberg. "It's an extension of my visit."

One caveat: you'll want to have confidence in staff's skills and level of knowledge before allowing them to provide patient education. Obviously, a well-trained RN can discuss more in-depth topics than a newly hired medical assistant.

Put technology to work

In addition to the usual fare (directions to your office, provider bios, insurance plans accepted), your Web site can feature customized educational handouts for patients to download, print, and read at their convenience. A page for frequently asked clinical questions might include how to prepare for minor office procedures, how to care for a wound, and other clinical issues specific to your practice.

At Adult and Pediatric Dermatology in Concord, Massachusetts, the trend is toward less paper and more online materials. Although this won't eliminate the need to provide written information in the office, patients will have the option to visit the practice's site and find comprehensive information about their conditions and treatments, along with links to national resources and support groups. For technology-savvy populations, this convenience and potential for proactive self-management could further increase patient buy-in to treatment regimens.

Technology you may already have in the office is also a potential educational tool. At Dermatology Associates of Tyler, in Texas, handouts on common dermatology conditions are stored in the computer system. A terminal and printer in each exam room make it convenient for dermatologists and staff to supply personalized information and instructions during office visits. "Having patient education material integrated into the EMR reminds staff to give it to patients, and we control what the patient is getting," says Lynne Stein, RN, practice administrator. "We wrote our own templates, customized for dermatology," she says, "and we've added to them over time. We gather information from many sources, one of our doctors edits the text, and we test it on patients to make sure they'll understand it."

Stein points out that it's important to write educational materials that patients can comprehend; aim for about an eighth-grade reading level. "We tend to talk above patient's heads. We'll say 'benign' and 'malignant,'" she says, "and some people don't understand those terms. You have to say 'It's cancer,' rather than 'It's malignant.'"

Promote good health

To drive home a message about the importance of something as universal as, for example, sunscreen use, dermatologists should provide information in as many forms as possible: tell patients about their condition, treatment plan, and what they might expect (auditory). Follow that conversation with a brochure and written instructions (visual). Finally, hand them a sample of sunscreen or the new medication you've prescribed (tactile).

A practice newsletter - printed or electronic - is an excellent way to convey information about common conditions and preventive care. An on-hold phone message might include factoids that stress the importance of regular mole screenings. (Be sure to change these periodically so the information doesn't become stale, causing patients to tune out.)

Teaching patients also means making them aware of the services you offer. Visit the lobby of Dermatology Associates of Tyler and you'll be greeted with a display board on an easel. Each month the practice highlights a different service or treatment. If dermatologists in your practice subspecialize or offer unique services, a display of this sort is one way to inform patients about that doctor's expertise.

However you decide to educate patients, make this means of involving them in their care a priority and you'll be pleased to see them begin to partner with you toward improved health. Decide what methods work best for you and fit your practice style, get staff involved, and enjoy the process. You can be sure your patients will appreciate the extra effort.

Educating patients to partner in care

Having in place a deliberate patient education program is an essential component of delivering high-quality dermatology care. Patients who fully understand their conditions make better partners in their care and are more likely to be willing to share the responsibility for managing their own health.

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Disclaimer: The material above has been prepared by Physicians Practice. It has not been reviewed by the DermQuest Editorial Board for its accuracy or reliability. Reference to any products, service, or other information does not constitute or imply endorsement, sponsorship, or recommendation by members of the Editorial Board.