Another reason why your patient education may be ineffective

Advice about health maintenance, like tobacco use, exercise, body mass index, sleep, alcohol consumption, and screening guidelines, is not always consistent with the health care professional’s own practice.  A study of 418 completed surveys from physicians, registered nurses, physician assistants and nurse practitioners concluded:

“Our analysis demonstrated discrepancies between patient education and what the provider practiced.”

So what does this mean?  Is the health care professional advising the patient to do things he or she doesn’t believe are a priority?  Is the health care professional advising the patient to do things without explaining how do succeed?

Of course these discrepancies will come up frequently — getting enough sleep is the first one that comes to my mind.  So how do we handle it?

Pay attention when you teach.  You don’t have to reveal adherence is an issue for you, too.   But notice when you are advising the patient to do something you are not doing yourself.  Then think about why you are not doing it, and incorporate that understanding into your conversation.  For example, if you don’t get enough sleep, it may be related to too busy a schedule or too much to think about and bedtime.  Assess the patient’s challenges, which may not be the same as yours.  Then use motivational interviewing to help the patient problem solve.  Provide resources when available.

Being aware of your own issues can help you be more sensitive to the plight of the patient.  This awareness helps you bring the discussion to a level beyond a pronouncement, like “lose weight,” to a conversation of how to optimize healthy habits now.  In a discussion, you may learn the patient doesn’t understand the risks of the behavior, or wants to succeed, but doesn’t know.  Your teaching may be ineffective because you only give the patient assignments, without offering the health coaching to guide the patient through the behavior change.

Patient-centered care means health care is a negotiation process.  The goal is to optimize health outcomes by working within the skills, resources, and situation presented by the patient.  It is not more work.  It is the work.


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