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Empowered Patients Motivate Clinic to Seek Additional Resources
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With extra support from their nursing staff, the physicians at Duke Family Medical Center have successfully empowered their Black patients to take control of their health, without extending the office visit or inconveniencing clinic staff.
Overcoming the Challenges of the Office Visit
The consequences of the limited time a doctor gets to spend with a patient during a typical office visit can be unpleasant for all parties involved. Physicians trying to rattle off recommendations they have for their patients often end up feeling like a broken record or even worse—a nagging parent. All the while, they envision the host of problems their patient will face if they don’t take better care of themselves. The patient, often feeling ashamed about their condition and unhealthy lifestyle in the first place, might not want to take up the doctor’s time to talk about how addressing their hypertension or diabetes would dramatically change their life—which can be a very frightening proposition.
The limitations of the office visit can also exacerbate existing health disparities for patients from racial and ethic minority groups. Studies suggest that several characteristics of the clinical encounter increase the likelihood that stereotypes, prejudice, or clinical uncertainty may influence the quality of care for minorities (van Ryn, 2002).
How did they do it?
Hayden Bosworth, a research professor, along with colleagues at the Duke University Medical Center developed a 12 month intervention designed to help patients improve their diabetes and cardiovascular disease management.
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Patients received printed education materials at their office visit to take home and read.
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Nurses were trained to speak with patients over the phone and coach them on how to improve their disease management.
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Nurses made monthly calls for one year to the patients to discuss their heart disease and diabetes.
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Nurses communicated with the physicians about their patients’ status in order to trigger appropriate medication adjustments.
What does the future hold?
From firsthand experience, doctors, patients, and administrators agreed that this program improved patient outcomes and provided benefit to all clinic staff involved. Dr. Gloria Trujillo, director of the Duke Family Medical Center, praises the program for its ability to “get patients talking about their condition and help make it part of their everyday language.” Additionally, the program has been so successful, that her staff have decided to seek additional funds in order to train more nurses and improve care for more patients.
Want to learn more?
The Cholesterol, Hypertension, and Glucose Education (CHANGE) program was developed by researchers at the Duke University Medical Center and is being formally evaluated through a grant from Finding Answers: Disparities Research for Change, a national program of the Robert Wood Johnson Foundation.
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