Flipping the clinic

Advocates of patient-centered care talk of “flipping the clinic” to create an environment in which everything, from the sign-in process to how patient-provider conversations are conducted, is designed with the patient experience foremost in mind.

So here’s a really radical thought. What would happen if we took this one step farther and flipped the flip? What if patients also became more mindful of the provider experience and, by extension, more supportive and understanding of their doctor, their nurse and others involved in their care? What might we gain as a result?

It’s a novel idea raised ┬áby Natasha Gajewski, a patient advocate and innovator who recently blogged about attending a Flip the Clinic symposium hosted by the Robert Wood Johnson Foundation and hearing some of the success stories about patients who were empowered to become full participants in their care. Seeing how rewarding it was for clinicians to help make this happen, Gajewski reflects:

… [J]oy and satisfaction are apparently in short supply amongst care providers, particularly those on the front lines. So I find it curious we focus so much attention on salvaging the wellbeing of the patient, when studies and the emerging crisis in primary care suggest that more attention needs to be given to improving the wellbeing of clinicians.

Then she asks the million-dollar question: “Could patients cure clinician burnout and other problems in our healthcare system?”

In one of those moments of synchronicity, I came across Gajewski’s online posting at the same time I was reading Dr. Danielle Ofri’s new book, “What Doctors Feel,” about the undeniable – and sometimes overwhelming – role of emotion in the practice of medicine. Then, to clinch it, New York Times contributor Dr. Pauline Chen wrote this week about the growing problem of clinician burnout and how to lessen it.

It would be hard to find a health care provider in the U.S. these days who isn’t under tremendous stress at least part of the time. Although stress is inherent in the health care professions, it’s being ratcheted up and up and up by constant change, increasing demands on people’s time and energy, and resources that are becoming ever more strained.

While most Americans are probably aware of this, one has to wonder how well the average person understands the connection between frazzled, exhausted, unhappy clinicians and unsatisfactory patient experiences.

Dr. Chen lays it out for us:

Research over the last few years has revealed that unrelenting job pressures cause two-thirds of fully trained doctors to experience the emotional, mental and physical exhaustion characteristic of burnout. Health care workers who are burned out are at higher risk for substance abuse, lying, cheating and even suicide. They tend to make more errors and lose their sense of empathy for others. And they are more prone to leave clinical practice.

Do patients care? More than a few people might react the same way as one of Dr. Chen’s online readers who called it professional narcissism: “Enough about how physicians and other medical professionals’ lives are so difficult. We all have jobs that are hard to do.”

But I would hope this is a minority view. At its core, health care is about relationships between human beings. It’s hard for the parties to truly engage with each other when one of them is physically and mentally overloaded, frustrated and on the verge of burnout.

This isn’t to say that provider satisfaction should be the sole responsibility of patients. Patients often have enough to handle without also worrying about managing the morale of their health care team.

But patients do have a stake in this, whether they realize it or not. So, to go back to Gajewski’s question: Is there something we can do about it?

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