Doctor Patient Relations

Prescribing Change: 3 Essential Parts of Getting Patients to Follow Treatment Plans

By Steve Vargo, OD

Dec. 9, 2020

Part two of two-part series

In my new book, “Prescribing Change: How to Make Connections, Influence Decisions and Get Patients to Buy into Change,” I focus on enhancing patient outcomes by getting patients to not just hear the information that doctors provide, but act on it. In part 1 of this two-part series, I introduced the first four parts of what I call The C.O.N.N.E.C.T. Method.

Curiosity is Caring
Ouch! Where Does it Hurt?
No Involvement. No Improvement
No Time Like Showtime
Earn Trust
Conquer Objections
Tell Me What to Do

This is an approach to clinical care that drives improved compliance, enhanced outcomes and greater financial success. In this article I’ll describe the final three parts.

Earn Trust: Emphasize Your Authority, Capabilities & Results
Most medical professionals likely believe their title and degree affords them a high level of trust with patients. People do trust doctors, but not nearly as much as they used to. A study conducted in 1975 found that 80 percent of the public had confidence in the medical system. A study from two years ago found that number to be 34 percent.1

Doctors have to be more proactive in earning the trust of their patients. I find there are three key areas to building trust with patients. These are authority, capabilities and results.

Authority: All optometrists are experts in their field, but that by itself won’t deliver an unending line of patients seeking care from you. For that, you’ll have to cross over from expert to authority. Authorities don’t just have clinical abilities, they become key voices in their field or area of expertise. You could start by reaching out to local media outlets or publications and offering to be interviewed, then share that content with your patients.

Capabilities: Authority is part reputation, but you must back that up with capabilities! While we all consider ourselves eyecare experts, some ODs develop their skills to reach “guru” status. This could be in a particular area like dry eye or specialty contact lenses.

Results: Proof always trumps claims. If you can consistently deliver great results for your patients in any particular area, don’t keep that a secret. Build that into your marketing and messaging.

When current and prospective patients view you as an authority, recognize your capabilities, and are aware of the results you’ve generated, you’ll have much greater influence with patients.

Conquer Objections: Listen, Repeat Back & Reposition Your Argument
“I’ll think about it, doc.”
“I have to talk to my spouse first.”
“Does my insurance cover that?”

These are the sounds of objections. Often, objections are silent, never verbalized to the doctor.

A group of opticians once told me that patients regularly agree with the doctor, but change their mind when they get to the optical.

I doubt that’s true. More likely, the patient never actually agreed with the doctor, but rather chose not to openly reject the recommendations of a medical professional.

In any industry, people have a variety of reasons for not moving forward with the purchase of a product or service. If a patient has an objection, whether silent or verbalized, it’s best to address that objection in a way that doesn’t evoke defensiveness or further resistance.

I recommend the following three-step approach:
Step 1: Listen to the patient without interruption. This communicates empathy and understanding

Step 2: Repeat the patient’s concern back to him or her. This demonstrates you were listening. It’s important in these situations that people feel heard. This also serves as an opportunity to clear up any miscommunications or inaccuracies in the patient’s understanding

Step 3: Reposition your argument for change (taking the objection into consideration). This may involve a concession on your part (if acceptable), but also serves as an opportunity to reiterate to the patient what he or she is giving up by not opting for the best course of action.

I also recommend pausing periodically during the exam to ask if the patient has any concerns about what you are discussing. It’s better to deal with objections earlier than later.

Tell Me What to Do: Master the Art of Motivational Interviewing
It’s difficult to be influential with patients in getting them to change when they are essentially telling us, “Don’t tell me what to do!”

There is a natural human tendency to push back or resist when told what to do. Consistent with the theme of my book, information alone is often ineffective in getting people to change. From a neurological perspective, the logical side of our brain is responsible for skepticism and judgment. This is why it’s important to connect with people on an emotional level and get them to explore their own motivations for change.

There is a science in healthcare called Motivational Interviewing that does just that. Here are examples of new approaches to resistant or ambivalent patients:

Ask the patient to rate on a scale from 1 to 10 their motivation for pursuing a certain action or behavior, like losing weight to better control diabetes. If the patient gives a low number, like 3, ask the patient why he/she didn’t pick a 4.

This forces the patient to verbalize his or her own intrinsic reasons for change. This patient may not want to change for your reasons, but she may desire to lose weight so she can be more active with her grandchildren.

Another strategy is to get the patient to discuss pros and cons of changing a behavior or acting on the information you’re providing.

If a patient is not ready to fully commit at this time, consider if a smaller change would be acceptable to the patient, or allow the patient time to consider the options and revisit the topic at a future visit.

It’s very possible that at the next visit that patient will no longer be saying, “Don’t tell me what to do!” but will be willing to follow his/her own motivations for change and looking to you for guidance.

References
1. https://www.modernhealthcare.com/opinion-editorial/commentary-erosion-trust-threatens-essential-element-practicing-medicine

Steve Vargo, OD, MBA, is a practice consultant, speaker and author. His latest book is “Prescribing Change: How to Make Connections, Influence Decisions and Get Patients to Buy into Change.” To contact him: SVargo@idoc.net 

 

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