conversation is an engine

The better to listen

Allina employs people to work the space between a physician’s prescriptives and the patient’s adherence to said advice and prescriptions. (May 6 StarTribune: Care Guides show another face of health reform)

Maura Lerner’s story shows a comical side to healthcare that should surprise no one. The comedy is not that hospital systems would employ people with little to no medical training (that makes good sense to me). The comedy is how many patients and physicians have learned all sorts of dysfunctional ways of interacting and not listening to each other.

Betsy Snyder, 23, never wears a white coat on the job. She wouldn’t want her patients to get the wrong idea.

Care guides make sense because they feed corporate efficiency objectives of moving physicians quickly from patient to patient, which serves to maximize those costly human assets. And certainly care guides will try hard to work within their contractual obligation to not practice medicine not matter how hard the kindly older woman pushes for such advice (especially since they’ll quickly be out of a job if they do).

The key common-sensical notion here is that the care guide becomes another interpreter of the physician instructions. And as they discuss prescriptions and compliance with the patient, they are another voice advocating for improvement. And since they arrive without the baggage of years of training they are free to listen.

And listening is the key. Listening and talking—such simple things—but these are the missing ingredients in treatment. Just because a physician prescribes doesn’t mean a patient complies. But talking it through, why, maybe it is actually a kind of therapy trigger.

Care Guides are a positive development as healthcare corporations try to relate to humans and their conditions.

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Image credit: Courtney Perry via StarTribune