Patient Empowerment: A “Design-Thinking” Perspective
This past week marked the second annual Mayo Clinic Transform Symposium - a meeting of innovators in the medical field.
Following the wrap-up of the Symposium, I had a chance to ask a few questions to two of Mayo Clinic’s advocates of “design-thinking” and “minimally disruptive medicine”.
In a two-part series, I would like to share with you two though-provoking videos from the 2009 Symposium discussing patient empowerment, and the role of communication in enhancing the doctor-patient relationship. The videos are followed by brief Q & A’s with the speakers.
*Maggie Breslin has been working at Mayo Clinic as a designer/researcher in the design research group in the Center for Innovation for 5 years. She collaborates with Dr. Victor Montori's KER Unit. She has a background in film, tv, animation, and games and in 2005 she received her Masters in Design from Carnegie Mellon University.
Maggie was kind enough to take the time to answer a few questions that I had:
With your access to patient interactions, what are some general trends you have noticed that contribute to problems in the doctor-patient relationship?
One big thing that I think is overlooked is the history of provider-patient interactions and the ritual of the experience. Visits – including the spaces, the people, and processes – have remained virtually unchanged fore more than 50 years. For a long time it didn't serve anyone for the patient to be super engaged so we didn't cultivate that behavior … and now, all of a sudden we want patients to be able to be incredibly forceful in an environment where that was generally discouraged. It's going to take more than that. I do this work for a living and I still have to work up the courage to ask my doctor a question that I'm afraid she will think is stupid.
How do you think doctors can do a better job of engaging their patients in the healthcare process?
I think both people play a role as participants in a conversation. In my experience the trick is to get the patient to ask a question. Almost all physicians are happy to answer the question and it tells them a bit more about the patient. Physicians have too much knowledge to share everything they know with patients, so in the absence of anything else, they rely on assumptions and habit to guide the conversation. Based on my observations, all it usually takes is a question from the patient - which begins to tell the physician something about what is important to the patient, getting the physician onto another more personalized track.
Doctors can help their patients feel comfortable enough to ask questions by giving them information in a language and context they understand, addressing quality of life issues, providing time, and asking them questions about what they are hoping for and what they are afraid of. You have to woo them a bit.
You mention the choices that are made daily by healthcare providers – what can healthcare providers do to put rich conversations at the center of their interactions every day?
The biggest thing may be their willingness to break their routine and try tools that put the conversation in the hands of the patient. This seems risky to physicians because it challenges their tight timelines/schedules and can make them feel a bit vulnerable, but from what we've seen, it rarely expands the visit length by much and often allows the physician to help the patient in a much more powerful way-which is an amazing feeling.
How is the internet changing the role/frequency/quality of conversation in healthcare?
I think the internet is a technology tool that can provide increased opportunities and access, and more teachable moments for patients and physicians to talk to each other. But, for it to be truly useful it needs to augment an existing behavior. It is probably possible for a physician and a patient to build a conversational relationship entirely through online conversation, but the history and model of care delivery in the US makes me think it will probably need to be started, or at least reinforced, in face to face encounters.