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5 T's for Authentic Patient/Clinician Partnerships


Healthcare continues to be in the news as we, as a nation, strive to improve care, lower cost and engage patients. I have spent the past 16 months thinking, writing, and learning about this thorny topic from 3 perspectives-- as an educator, as a newbie in the healthcare industry and, most importantly, as a patient.

When I think of the word "partner" in my life, it was never associated with unequal power dynamics, mindless deference or paternalistic thinking. As most of us as patients know, far too many healthcare environments remain in cultures where there is only one expert in our care who knows best, prescribes (tells us) what we now must do and often, even if well meaning, fails to include us authentically in the process of healing or preventing illness.

When I think of the new way healthcare can reinvent partnerships, it requires 5 words that represent the kind of partner I would want in sports, in business, or in a relationship/marriage. How might we re-invent a culture where there are two experts in every healthcare encounter--- one is the provider(s) who knows so much about the human body and the other is the person who receives care-- who knows the most about herself.

Let's reinvent healthcare communities in what I call the "5 T's of patients as authentic partners."

Teammate: Stockton/Malone, Buffet/Munger, Simon/Garfunkel, and Merritt/Sauerbrey... Ok... you may not know the last one but I feel pretty good about calling my spouse and partner a great teammate. When I think about what is required and possible in healthcare, it requires us to see each other as teammates who bring special expertise to the table. I believe it's paramount that for healthcare to change and truly engage and connect with patients, they must see one another as true teammates.

Transparency: Think about almost every healthcare appointment you've ever been through... do you know much about your provider or healthcare team members? Is there a sense of transparency on what is happening behind the curtains, screens and computers? Opennotes begins to lift the veil of secrecy about your healthcare data and remember-- it is YOUR data-- so you should be able to see what is written about you and help the team to successfully partner to manage your condition.

I've written elsewhere and discuss frequently, the opportunity to work closely with patients to assist in all aspects of healthcare. Patients come from many academic disciplines and life experiences and are often grateful for their care. How might their perspective be mobilized to help solve seemingly mundane issues that are beyond the clinical aspects (i.e. financial, logistical, culture). At minimum, they might provide a perspective that is new and, if welcomed and embraced, they might even create something transformational in healthcare practices. Getting to know patients as a whole person might be the most important thing you do for patients and for your practice.

Time: Our current healthcare system generally works to maximize efficiency. The majority of us see our doctors for 10 minutes or less to describe often very challenging symptoms and complicated health stories. How might we help our partners understand and work to change the dominant paradigm that says we are to arrive 15 minutes before our "scheduled" time, go into a room to wait a bit longer and then (more often than we'd like) watch a truly committed doctor look like they are behind schedule and it's our appointment where they need to 'catch up.' What are other models that exist to truly get to know our healthcare team... to have a real chance to talk about who we are as authentic partners? How might we rearrange schedules so they are not simply done "on the hour" but rather done by knowledge of the patient about how much time might be needed -- some more, some less-- and we use the power of big data, algorithms and other AI to inform schedules, while understanding the issues with efficiency and the need to serve a large population of patients. Time is a precious commodity if we are to be authentic partners.

Teacher: Certainly physicians and other health providers work hard to teach us about ourselves and how our bodies work... but how often are we asked about ways our providers might learn from us? If we were to open up as healthcare providers to really listen in order to learn from our patients, what might we learn? How might we train medical students (and other healthcare students) to be learners from their patients? What if patients were welcomed in waiting rooms with information on how they might work to teach their providers something new about themselves and or about something they are particularly expert? Providing environments where the teaching/learning continuum works both ways would be an excellent start to creating positive partnerships.

Trust: If we can somehow accomplish the first 4 T's, then TRUST is developed, fostered and flourishes. Like every good partnership you have ever been apart of in your life, we all know trust is the critical component- how might we partner to develop?

How might the 5 T's define the new partnerships in healthcare between patients and providers? What would happen if every encounter to receive care or prevent illness assured that we worked toward developing all 5 T's? What ideas do you have to develop authentic partners in our care? How might patients be critical to help us find solutions to improving health outcomes, lowering costs and developing the sorts of relationships where we would say... well it's not great that I'm going through some healthcare challenge, but I look forward to seeing my team and working collaboratively to solve it. I think it's possible... let's start a movement together to make this a reality!

What do you think?

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