Not especially experienced it before not chronic

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Unformatted text preview: a truthful answer anyway. One major problem is that the provider does One not receive feedback on how the interaction went and if info was communicated effectively, if patient followed instructions, and if patient was cured, in particular if patient does not return. does What was good, what could be improved. Question: Do you receive a questionnaire or evaluation Do form from your physician after a visit (by phone, mail, etc.)? phone, Provider may not know when a satisfactory Provider personal relationship has been formed with patient. patient. Many patients cautious – will just switch Many providers rather than give negative feedback. providers Patients whose treatments have failed are more Patients likely to return than those with successes. likely Learning is fostered more by positive feedback Learning than negative. than Positive feedback tells you what you are doing Positive right (and should continue). right Negative feedback only tells you what not to Negative do, not what to do instead. do, So physicians need both, but often get none or So mostly negative feedback. mostly There are many negative results of poor There patient-provider communication. patient-provider Patients less likely to use medical services in Patients the future if not satisfied. the Patients more likely to turn to non-traditional Patients services that satisfy emotional needs rather than medical needs. than Patients less likely to obtain medical checkups. Patients more likely to change doctors. Patients more likely to file complaint Patients causing time consuming activities for physician as well as patient. physician Nonadherence to Treatment Regimens Estimates for nonadherence are between 15% Estimates 93% with an average of 26%. 93% Short term antibiotic treatment – 30% Short nonadherence. nonadherence. About 80% drop out of lifestyle change About programs. programs. About 70% do not take prescriptions exactly as About prescribed (either partial or total nonadherence). nonadherence). Children with ear infection – 5% total adhered Children to instructions. to Adherence very high with HIV, arthritis, Adherence gastrointestinal disorders and cancer. gastrointestinal Adherence very low with pulmonary disease, Adherence diabetes, and sleep disorders. diabetes, More than 80% of patients who receive More behavioral change recommendations from their doctors such as stop smoking or restrict diet, fail to follow through. fail Even cardiac rehab patients – only 66% - 77% Even adherence! How do we measure adherence? Self-report: We ask patients, family members, Self-report: physician, etc. physician, Not reliable. Lie to look more socially desirable. Faulty or biased memory. Biological measures Blood tests. Urine/stool samples. Carbon monoxide tests (for smoking cessation) Good but expensive and cumbersome to do Good frequently. frequently. High Tech Devices Pill bottles with microchip that records when Pill opened. opened. Expensive. Not complete – does not tell if...
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