WIHI - A Podcast from the Institute for Healthcare Improvement
Health & Fitness:Medicine
Date: August 9, 2012
Featuring:
One of the most common phrases used to describe patients who are not taking their prescribed medications or following up on the recommendations of their health care providers is “non-compliant.” What if we viewed the behavior as an act of civil disobedience instead?
This provocative notion definitely got the attention of health professionals in the audience at IHI’s 13th Annual Summit on Improving Patient Care in the Office Practice and the Community (March 18-20, 2012). It’s the thinking of Dr. Victor Montori, a diabetologist and researcher at Mayo Clinic whose keynote remarks at the gathering were, in part, intended to shake up common and sometimes negative assumptions about patients with chronic diseases who don’t seem to be holding up their half of the bargain. Dr. Montori invites all of us to consider the work of being a chronically ill patient, and the burden of increased expectations to follow regimens that don’t easily fit into a patient’s daily life, social circumstances, preferences, and more.
What’s the alternative? Dr. Montori and colleagues call it “minimally disruptive medicine,” and WIHI invites you to learn more about this change of mindset and approach to chronic disease and what it can look like in practice. Host Madge Kaplan and Dr. Montori are joined by Nilay Shah, a health services researcher at Mayo Clinic. Both Drs. Shah and Montori argue that with the growth of patient-centered medical homes and numerous other initiatives that assume a greater role for patients and family members in managing chronic conditions, it’s a critical moment to examine what added workload this implies. The two argue that some of the burden on patients can be reduced if approaches to care are married with efforts to reduce unnecessary and costly over-treatment.
Think of it this way, says Dr. Montori: So-called “non-compliance” is actually an alarm system for a health care system that’s failing patients. The goal needs to be shifting and sharing responsibility for chronic disease with patients and families — not shifting the burden.
To learn a bit more about minimally disruptive medicine, check out the story of Susan and John.
WIHI: How to Speak Up for Safety
WIHI: Building Systems of Safety
WIHI: Engaging and Supporting Family Caregivers
WIHI: Improving Patient Experience: What's Working, What's Not
WIHI: What's Next for Electronic Health Records
WIHI: How Health Care Can Accelerate Health Equity
WIHI: 100 Million Healthier Lives: From Vision to Reality
WIHI: Five Practical Strategies for Managing Successful Improvement Projects
WIHI: Nurturing Trust: Addiction and Maternal and Newborn Health
WIHI: Health Care in Motion: Making Sense of a Moving Picture
WIHI: Joy in Work: An Antidote to Today's Burnout in Health Care
WIHI: The Opioid Crisis: How Health Care and the Community Can Act
WIHI: Breaking the Rules: Lessons from IHI’s Leadership Alliance
WIHI: The New World of Co-producing Health and Health Care
WIHI: A New Framework for Safety in Ambulatory Care
WIHI: Making Data Work for Quality Improvement
WIHI: Morality Matters: How to Reset the Mission of Quality Improvement
WIHI: New Tools and Thinking for Shared Decision Making
WIHI: Realizing “What Matters” (to Patients and Families)
WIHI: Personal Mastery for Transformational Leadership
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