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4 Approaches to Patient Responsibility and Self-Determination

By February 6, 2023February 23rd, 2023Family Medicine

Patient health is a 24/7/365 mission but convincing patients to follow sound medical advice and do what’s right for their health can be difficult. While technology is facilitating patient communication outside of the practitioner’s office, you can’t follow patients home to ensure they are following treatment protocol.

Practitioners can provide a diagnosis, treatment plan, and other groundwork, but patients have to invest in their own success. To assist patients in this goal, practitioners can employ tactics to persuade them to be more diligent and committed. Instilling treatment buy-in, responsibility, and ultimately patient self-determination can be achieved by following these steps to motivate patients.

1. Identify Motivational Needs

While practitioners should be cautious of their implicit biases, they should also actively try to identify which patients are likely to have motivational and compliance problems upfront. Here are some signs motivation and accountability might be at issue:

  • A history of non-compliance
  • A lifestyle not conducive to compliance
  • A poor emotional support network
  • Poor patient-provider relationship
  • A chronic health condition

Some practitioners make the mistake of mandating what the patient should do and lecturing them on the importance of treatment engagement. But this unilateral approach is not optimal for the patient–and ultimately practitioner–success. Some may even attempt to scare patients into compliance but fear can lead to patient disengagement, rather than engagement.

It’s easy to fall back on these tactics when the stakes are so high but alternative strategies are available to practitioners prepared to approach patient motivation more sustainably and organically. New interview techniques allow for both the assessment and implementation of a patient’s motivational needs in ways that are positive and self-reinforcing.

Interviews with the following techniques can help identify motivational needs while also helping patients process the reasons why treatment is important. Many of these tips fit within an evidence-based medicine interview framework that emphasizes the importance of patient feedback.

  • Open-ended questions
  • Assess health literacy
  • Provide affirmations
  • Reflective listening
  • Patient-friendly summarization

2. Facilitate Communication

A quality motivational and evidence-based patient interview establishes an open line of communication. According to recent research, this is essential to patient accountability and self-management.

Digital patient portals are one way to foster accountability and have become a fixture in primary care settings. They can get very sophisticated and at times, cost-prohibitive, but stripped-down versions are available.

Through portals, patients can access their medical histories, prescriptions and refill requests, practitioner calendars, and secure messaging systems to safely contact their practitioner’s office. Patient portals are useful to all patients but provide additional benefits to those who are chronically ill. Motivation, even when present, can be fleeting. But digital patient portals provide an environment of consistency and stability that can help patients succeed in the long term.

3. Provide Treatment Plan Specificity

While practitioners may be hesitant to overwhelm by providing patients with too many details, a deeper understanding of the ‘why’ can foster buy-in. Clear, concise instructions that reflect the patient’s treatment plan preferences can also promote patient accountability.

Motivation can be negatively affected by treatment plans patients don’t understand or lack specifics. Practitioners must be transparent when outlining treatment goals to encourage patients and help them to see the long-term benefits of a specific treatment plan.

Treatment may seem simple to the practitioner but managing medications, scheduling refills, making appointments, and learning to use the patent portal can be daunting without clear instructions. Point of care testing, patient analytics platforms, and patent portals create a system of immediate feedback and structure for patients and practitioners. This clear progression can help patients more easily see the road to recovery.

Offer a treatment plan the patient finds sensible and transparent, encouraging patient consistency within a structured system that fosters good habits. Patients are able to refer to the details of their treatment plan regularly and can reach out with questions or report updates with patient portals. This transparency alone can foster trust between patient and practitioner, encouraging responsibility in patients who like being held accountable.

4. Educate Patients

One factor that negatively affects patient motivation is a lack of collaboration. If a patient feels dictated to, rather than included in, their own treatment, they are less likely to participate. One of the biggest barriers to a collaborative relationship is patient health knowledge. Helping to educate a patient is an ideal way to foster collaboration but this tactic comes with its own challenges.

Patients face a lot of conflicting and misleading health information without often knowing where else to turn. Expert sources, while more trustworthy, can be too complex for patients. Practitioners must provide access to quality information that connects with patients where they are in their health journey. Encouraging the use of quality health resources and directly addressing misinformation and its effects can address both challenges.

Find quality sources that are easy for the patient to find and evaluate before recommending them. While many practitioners loathe when patients gather information about their conditions online, it is a fact of modern medicine that patients will seek to inform themselves. This proactivity should be affirmed and, if necessary, be paired with sources of your choosing.

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