Though the popular catch-phrase “patient-centered care” is often used, but it may be missing the mark because needs are not being met in this COVID-19 era of care. Patient drop outs and refusals are common with telemedicine becoming more common, as a recent telemedicine Cochran Database study shows. In this article, we propose a novel approach to patient-centered care that can be applied in virtual, telemedicine-style practices and in-person clinics alike.
What do Patients Really Want from Patient-Centered Care?
Taking a moment to consider this question leads us to factor in patient perceptions of the medical care, the type of care they actually experience and by contrast, what do they really want?
A majority of your patients are not coming to you to ask for specific lab tests, procedure, medication or supplement. Though do you market your practice as such by emphasizing the latest treatment technology or diagnostic tool? It’s impressive to your peers, but your patients come to you because they feel less than optimal and want to feel better. When it comes right down to it, your practice is selling wellness and a means to meet your patient’s needs in this quest for health.
Understanding Your Patient’s Journey to Wellness
Ask a patient if they are interested in lifestyle medicine, and they will likely tell you, of course that sounds like patient-centered care. The recent upswell of interest in “lifestyle medicine” by practitioners and patients alike is evidence that this approach offers something compelling that is aligned with today’s patient needs. This means that in marketing terms, every practice should first identify the problem and then propose a solution. The value proposition should match what the patient really wants, which in this case is to experience a state of wellness.
For the purpose of this article, we’ll set aside a small subset of patients who genuinely require a panel of specialty lab tests for differential diagnosis. This article focuses on a new approach to patient care that can easily applied to a large number of today’s patients, especially when delivered online or in groups. It’s called Lifestyle Medicine.
What is Lifestyle Medicine?
We can learn a lot from the six foundational naturopathic principles that provide a solid reference framework, which “honors the body’s innate wisdom to heal and gives patients the tools for lifelong wellness.” They are defined from the Institute of Natural Medicine, a non-profit advocate for naturopathic medicine, as the following:
- The Healing Power of Nature: the body has an inherent ability to heal itself.
- Identify and Treat the Cause: look beyond the symptoms and seek out the cause of the issue.
- First Do No Harm: Use the most natural and least harmful therapies.
- Doctor as Teacher: Educate patients (and other doctors) about the steps to achieve and maintain wellness.
- Treat the Whole Person: View and treat the body as physical and spiritual entity that is integrated and whole.
- Prevention: Always focus on overall health, wellness and prevention.
Now doesn’t that sound like patient centered care? Only when all of these important principles are applied, then other diagnostics such as epigenetics and nutrigenomics can be leveraged in a programmatic system. Only then will we see positive shifts in the patient landscape. Anecdotal feedback from practitioners is that when this approach is applied, patients report feeling better within just a few weeks. Once the overall picture is clarified, then other lab tests can be called upon if necessary to focus in on the remaining symptoms.
The other benefit to this approach is that by reducing negative inputs to the physical system and increasing positive inputs, this sets in motion a shift that will, in and of itself, lead the patient toward a desire to really want to feel good. It helps them begin to establish sustainable patterns of diet, exercise and stress reduction that will help maintain the desired results in the long term.
The Logistics of Patient-Centered Care
Providing a simple and clear program will help patients move through this process in an efficient manner and will motivate patients with quick results that increase compliance and follow-through. In a more allopathic-oriented practice approach it is not uncommon for patients to begin care only to fade away due to lack of a clear program. This is frustrating for both the patient and the practitioner, especially when it becomes a repetitive pattern that never delivers the satisfaction of realizing the promise of wellness expected through lifestyle medicine.
It is important for the patient to realize maximum value from the care being offered and a clearly defined program can help them achieve this goal.
In the same way that one wouldn’t enroll in a medical school that said “just keep coming until you lose interest and we’re not really sure what you’ll get out of it”, patients are frequently asked to do just this with their health care. Creating a programmatic, systematized approach provides a structure that allows the process to be more efficiently managed, with defined phases of care, and built-in accountability for both parties along with quantified results measured along the way.
A true, patient-centered lifestyle medicine program includes:
- A comprehensive questionnaire to provide a baseline to quantify progress with reassessments at intervals.
- A detoxification and elimination diet phase to remove negative inputs.
- A nutrition-centered phase providing sustainable diet and lifestyle templates providing positive inputs.
- A wellness/maintenance phase, or a more condition-specific branch as indicated.
- Easy patient-practitioner communications.
- Frequent email and text reminders to help patients stay on track and enhance compliance.
- An easy system to fulfill prescriptions for high-quality dietary supplements when diet alone isn’t enough.
Creating and administering an online program infrastructure can be challenging, resource intensive and expensive so look for an integrated solution that will help practitioners deliver the best care within an affordable and user-friendly ecosystem. Additionally, find a technology partner who provides concierge-style hand holding during the implementation process.
Offering online lifestyle medicine programs for patients is an opportunity whose time has come and presents a win-win for both patients and practitioners. It offers an efficient and profitable way for practitioners to better leverage their time and help as many patients as possible. A well-run program will “teach them how to fish” and improve the likelihood that patients will continue to realize the promise of the care being offered for a long term, sustainable solution. Give patients what they really want- the gift of wellness.