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: End-of-Life Care and How Communities Can Become "Conversation Ready"
WIHI: 10 Things Every Hospital Needs to Know to Be Safe
WIHI: The Road to Team-Based Primary Care and Behavioral Health
WIHI: 100 Million Healthier Lives by 2020
WIHI: Optimizing Safety with the Electronic Health Record: The Latest on Glitches and Fixes from the Frontlines
WIHI: Better Care and Better Value for Hip and Knee Replacement
WIHI: Mental Health Care in the Hospital: Preventing Harm, Promoting Safety
WIHI: From Here to CLER: Graduate Medical Education and the Clinical Learning Environment Review (CLER)
WIHI: Tread Water No More! Making Sense of Patient Experience Data
WIHI: Preventing Financial Harm to Patients: The Costs of Care Initiative
WIHI: From Prehospital to In-Hospital: The Continuum for Time-Sensitive Care
WIHI: New Roles, New Routes for Managing Populations
WIHI: Making the Work of QI Less Draining and More Sustaining
WIHI: The Patient-Centered Medical Home: Early Results, Tough Scrutiny
WIHI: Partnering with Patients for Safety: The Next Phase of Work and Commitment
WIHI: Transforming Tensions and Tempers on Health Care Teams
WIHI: Reclaiming Empathy — Best Practices for Engaging with Patients
WIHI: Bright Spots for Patients with Complex Needs
WIHI: How High? How Low? Shared Decision Making Amidst Shifting (Hypertension) Guidelines
WIHI: Mobilizing Skilled Nursing Facilities to Reduce Avoidable Rehospitalizations
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