At the very heart of healthcare is the relationship between the patient and primary care provider or PCP. In today’s environment of health consumerism and rising medical costs, a good relationship with your PCP can result in better care and even cost savings.
As the CEO of a physician-led, clinically integrated care network, I’ve learned that for each aspect of care, there is a physician responsibility anda corresponding patient responsibility. Patients, in the end, are responsible for their health and their health-seeking behavior. Physicians are their trusted advisors. Both share a joint responsibility for the journey. And both benefit from shared guidelines — some explicit, some unspoken — that make the partnership work.
But what does a good relationship look like? Here are five goals to get you started:
#1 Trust and Transparency
Your first job as a patient is to choose a provider with whom you can have a mature, honest relationship, with joint responsibility for outcomes. The consequences of not having that trusting relationship with an individual physician or a care team can really hurt — without it you may avoid seeing the doctor when you should or be forced to rely on more expensive urgent care. From the provider’s side, he or she should show empathy but be honest. They should be willing to provide you access to your full medical records and be willing to answer questions. There should be no secrets between you.
#2 Honest Financial Discussions
Those in a good patient/doctor relationship are comfortable talking about costs and the impact of care on your financial situation. Any time your doctor makes a recommendation for a procedure, a test, or an appointment with another provider, they should be able and willing to answer your questions, like, “What is the cost? Are there alternatives?”
This doesn’t mean you and your doctor are making decisions based solely on cost. But you may have less expensive alternatives. Patients ultimately hold the responsibility to determine the best option for them.
#3 Mutually Agreed Health Goals
Doctors want to understand where patients want to be with their health, what they are willing to do, and not do, to get healthier. A doctor can advise, but they can’t make a patient do anything.
If you are a diabetes patient with an HBA1C level of 12, your doctor might suggest a goal of 8 and tell you what’s required to get there. But if you simply aren’t able or willing to make those changes, you can have that discussion. If you’re not able to do your part to achieve this goal, what are you willing to do? The patient and the provider together must negotiate a shared goal that the patient is willing to work on.
#4 Support for the Work
Patients need to have a basic understanding of the care, tests and assessments in their care plans, and they need to commit to following those plans. But helping patients follow through on that work — and it is work — is the job of the care team.
We know you patients have busy lives. Technology should automate the alerts, the reminders, and the scheduling. But it’s not good enough to say, “I sent you a reminder, you didn’t respond, and now look what’s happened a year later.” When a patient doesn’t show up for an appointment or respond to a request, the physician and the care team should personally reach out to say, “What’s happened in your life and how can I help you do what you need to be successful?”
The patient must set the goals, and we as care providers must deliver services that meets their unique, contextual needs. Patients make complex decisions all day, every day, related to their families, their jobs, their financial situations, their relationships. They can make those same complex decisions around healthcare. The patient-provider relationship needs to be a partnership.
These guidelines can help make the physician-patient relationship a true partnership in achieving the best possible health outcomes.
