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Focusing on the patient

Doctors used to be seen as authority figures who could not be questioned. But as society becomes more service oriented, patient-centered care has become something that the medical community is increasingly focused on. This week on WRVO's health and wellness show "Take Care," hosts Linda Lowen and Lorraine Rapp speak with Dr. Atul Grover of the Association of American Medical Colleges about how this emphasis is changing the way doctors are trained.

Linda Lowen: What is behind the trend of emphasizing doctor-patient communication in health care today? Is it coming from the top down or is it coming from the patients themselves?

Dr. Atul Grover: I think it’s coming from both places.  I think we, as physicians, in the medical community realize that we can be the best technical experts in the world and yet if we can’t communicate to our patients effectively about what we need to do to help them take care of themselves, what they need to do to take care of themselves as an individual, we’re not going to do a great job at keeping them healthy or getting them to recover from illness. And so, I think, it’s just a natural evolution of medicine that I think we’ve gained the public’s trust as far as being technically competent experts and we have ways to assure that. But even in our own public opinion research at the Association of American Medical Colleges, when we ask the general public ‘where do you think we’re falling short as people who educate and train physicians?’ they often say ‘you know, I really wish my doctor would spend more time with me, communicate with me more, have a better bedside manner.’ And so I think we’ve really taken it to heart that this is part of our responsibility and they’re directly related to how well our patients do in terms of their own health outcomes.

Lowen: Does all this patient-centered care improve outcomes? Are patients healthier as a result?

Dr. Grover: I think what we’re learning is that you can’t really address the patient’s needs without understanding what those needs are and there’s no substitute for good communication. You can define being patient-centered in a variety of different ways but I think at the end of the day, you need to understand what the patient’s goals are and what their life circumstances are. If I take an example like diabetes where we have some laboratory tests, hemoglobin A1 seizure blood sugars that we measure; I may be looked at, as a doctor, to see whether all my patients with diabetes are doing well and have those numbers in a normal range. But if my diabetic patient in front of me, really has more problems with trying to figure out what healthy foods to eat, trying to figure how they should be monitoring themselves at home, how they should be exercising, I’m never going to get their outcomes in terms of those blood lab measures to the point where they need to be – if I can’t understand where they’re coming from and what stops them from being healthier as a diabetic patient. I think we’re also beginning to find that being patient-centered also means having the right communication skills, not just to deal with our patients, but we have to have good appropriate communication among our teams and between providers as well in order for patient outcomes to be the best that they can. 

Lorraine Rapp: I wondered about personalities of people who go into medical school and I know we can’t generalize but the social aspect of their personality might be missing a little something. Does anybody in your field ever address this?

Dr. Grover: I think there’s a wide range of personalities and skill sets in the practice of medicine. Some of us are definitely better communicators than others. I would say our students though are becoming increasingly diverse from the perspective of their educational background, their skill sets and interest.

More of this interview can be heard on "Take Care," WRVO's health and wellness show Sunday at 6:30p.m. Support for this story comes from the Health Foundation for Western and Central New York.