Improving Education: Engaging Patients in Care for Optimal Results
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
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
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.