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The Sphere of Frustration in Health Care

In an earlier post entitled Where Is Your Health Leadership?, I outlined a four-quadrant model for how individuals and care teams can come together in different ways. Smack in the middle was the Sphere of Frustration and, unfortunately, this is where many of us get sucked into, willing or unwilling.

The purpose in this post is to explore the Sphere of Frustration in health care further, focusing on the patient (us) and the industry (e.g., physicians, clinicians). If you think about your physician appointments, they last about 13 to 18 minutes. During these 15 minutes (on average), how can frustration set in? It can in several different ways, in and outside of the exam room.

The Patient Sphere of Frustration

Here are a few examples of how frustration festers for patients:

Give me my data.  There are two levels of frustration here. First, there is getting electronic access to our data that is collected from a physician visit. Being able to track our health care procedures and results should be similar to managing our financial portfolio – data easily combined, tracked, and stored electronically.

Second, there is gaining access to data from medical devices, like the implantable variety. Meet Hugo Campos who is on a mission to gain access to the data from an implanted cardiac defibrillator. As he states, “I have this complex little computer implanted in my body, but I have no access to it.” You can watch his TEDx talk on this specific topic.

Gaining access to our health data is a big frustration point for patients.

Physicians die differently. A recent Wall Street Journal essay entitled Why Doctors Die Differently set off an active conversation. It seems that there are two different paths for physicians and patients. Physicians have more complete information and may take a different path than their patients. Patients take the high treatment path while doctors do not. Physicians have detailed advanced medical directives while most patients do not. Now, some of this needs to be the patient responsibility, but a more thorough discussion of medical options needs to occur.

Give me time for a meaningful conversation. The previous frustration point may relate to this one. Physicians are rushed. They have many patients to see in order to make their practice work. A medical practice is different than a psychology practice, for instance. At a basic level, the first is centered on pay for procedures, and the second is pay for an hour of time. Patients need to be prepared for their 15 minutes so that they get the most out of it. Physicians also need to be prepared to take a deep breath and carve out a few minutes to really listen and discuss concerns, issues, and questions.

The list of things that draw patients into the Sphere of Frustration can easily grow, but this gives a highlight of some. It is about data access, honest conversations, and time for one-on-one attention.

The Physician Sphere of Frustration

Let’s turn to what can raise the frustration of physicians. To be clear, I am not a physician, so this is based mostly on what I have read and heard at various conferences.

Patients are bringing in faulty information. We are in a digital age – no kidding! There is so much information flowing through various websites that it is very easy to not see the forest before the trees, as they say. Patients have access to this information and are bringing it into the physician office. It takes time to dispel, discuss, and/or confirm the data. Remember the 15 minutes. Well, now a portion of this time has to be dedicated to working through information collected from some blog! Physicians can get frustrated from this effort, as it drains their time and attention to try to determine the source and relevancy of data brought in.

Patients are only sharing partial information. Another frustration point with physicians is when patients do not give complete answers or share all relevant information during their visit. It could be from patients who stop taking some medication and don’t mention it to taking herbal remedies and not mentioning it. If a physician is trying to give complete care, then complete health care information is needed. Again, this is a source of physician frustration.

Technology is a barrier. Technology delivers value along with challenges. Physicians now have to enter data into a tablet or PC while talking to a patient, administering an exam, and doing all three within the 15 minute window of time! Another barrier is if – and when – a patient asks for an electronic summary of their visit. Electronic health record applications are new, so the learning curve is early. Figuring out how to make the data available electronically and securely raises the frustration levels.

Layered on both, now, is the growing popularity of social media. Patients are expecting physicians to take the time and connect with patients through blogs, Twitter, and – gasp – Facebook! You can feel the physician frustration rise as they try to balance all the technology challenges while trying to deliver high quality care.

The Sphere of Frustration – Health Care Style

There are many sides to a health care equation. Although only two are outlined here, and only three points in each, we see how various participants can be pulled into frustrating experiences. The point is not necessarily the frustrations themselves but recognizing them so they can be corrected.

For patients, there is a movement called e-patient. According to the Society of Participatory Medicine, this movement is described as a “cooperative model of health care that encourages and expects active involvement by all connected parties as integral to the full continuum of care.” Simply stated, it is about forming a health care partnership between patients and physicians.

Just as the term “e-patient” has been coined, it may be time for an e-physician as well. Relevant information and new ways to address many of the frustrations should be shared among physicians. There are physicians, today, that are leading this effort, but more need to join. The same can be said for patients, too; more need to join the e-patient movement.

By bringing together e-patients and e-physicians, the chance to be in the Empower quadrant increases. More importantly, it may create a barrier around the Sphere of Frustration so few enter in. This is the health care partnership we need to strive for.

It is time to shrink the Sphere of Frustration in our health care system. Are you ready to play your part?

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