20 Sep Creating a Cohesive Team: The Physician/Advanced Practitioner-Patient Relationship
By William Maples M.D.
Patients visit their physician/advanced practitioner when they are most vulnerable, and they need to have trust and confidence in their physician/advanced practitioner, especially when they discuss some of the most intimate details about their lives and families. However, when it comes to the physician/advanced practitioner-patient relationship, the two parties are not always aligned.
“Often physicians/advanced practitioners don’t understand what their patients want from them. It’s really quite simple — what matters most to patients is to be respected and listened carefully to by their physician/advanced practitioner,” says William Maples, M.D., President and Chief Executive Officer of The Institute for Healthcare Excellence (IHE).
When physicians/advanced practitioners build a trusting relationship with patients, it ultimately improves outcomes. On average, 50 percent of patients treated for chronic disease do not take their medicine as prescribed, a study on the success of high blood pressure treatments reported. And many times, that decision to take or skip a dose is significantly influenced by the physician/advanced practitioner-patient relationship.
“If you’re not really engaged with somebody and don’t trust them, and they recommend that you do something, would you do it? Would you follow through?” Dr. Maples says. “We jeopardize our patients’ safety and our patients’ outcomes if we do not develop a trusting, healing relationship between the patient and physician/advanced practitioner.”
Here are ways to improve the physician/advanced practitioner -patient relationship, according to Dr. Maples, who has worked with some of the nation’s top hospitals on these very efforts.
1. Understand how patient experience impacts quality, safety and efficiency. Hospital leaders need a deeper understanding and awareness of the impact that patient experience has, both on patient experience scores and the culture of the organization. “Achieving excellence in patient experience is more than achieving a top score or top reimbursement through initiatives such as Value Based Purchasing. It’s really about how we show up to work each day and the conversations we have between our patients and each other,” Dr. Maples says.
2. Transform the care model from a provider-centered approach to a patient-centered, team-based approach. Although physicians/advanced practitioners and caregivers work in teams, each and every decision is often made without consideration of the patient’s perspective. According to Dr. Maples, putting the patient at the center of every decision will improve their experience, as well as their outcomes.
“The culture of our organization is determined by the moment-to-moment conversations we have with patients and with each other,” says Dr. Maples. “By focusing on relationship-centered skills that foster a meaningful connection with patients and each other through recognizing emotions and responding appropriately, we can close the gaps in what patients want and what they receive.”
3. Provide an experiential skills-based learning platform. Learning in a skills-based format, where physicians/advanced practitioners and caregivers are actually practicing skills they need and use daily, can position a healthcare organization for improvement on all levels. Without addressing these foundational skills, Dr. Maples says an organization’s transformational journey will be slow and ineffective.
4. Engage physician leaders in the experience culture journey. Physician leaders are not always part of the conversation on how to improve the patient and staff experience, but it is necessary to invite them to lead this effort. “How in the world can we change a system if we don’t engage the leaders?” Dr. Maples says. “Engage physician leadership and believe in them…Their desire to help others, to improve a patient’s life, is really at their core. It’s why they went into medicine in the first place and it’s what they really want to deliver.”
The key to successful culture transformation, says Dr. Maples, is identifying physician leaders who support the effort to rekindle relationship-based tools. Once identified, train them to facilitate skills-based work with their colleagues to enhance the entire team’s journey. Respected physician and allied health facilitators creating a safe place to practice, and nurture relationships enhances the learning and helps incorporate these skills into everyday conversations.
“There is no shortage of physicians/advanced practitioners and caregivers who are willing to help improve the physician/advanced practitioner-patient relationship, as long as they know that leadership embraces the work and there is a commitment to supply the resources needed to do the work. We just have to nurture that and bring it forward,” Dr. Maples says.
The Institute for Healthcare Excellence partners with healthcare organizations to nurture relational skills necessary to create a culture that embraces trust, respect, compassion, and teamwork – creating an environment where quality, safety, and efficiency can flourish. Through this work, physicians, nurses, and the caregiver team reconnect to purpose and restore joy to the practice of medicine. The result of the culture-transforming work is a restoration of humanity to medicine.