There’s little I enjoy more than sharing with health professionals the Flourishing Treatment Approach and training them, in less than two hours, in a few of its strengths-based skills – that often are the missing link to patient involvement and activation.
It is rich to see them work among themselves and gain new insights and skills. It is remarkable to see them nod in agreement when they hear, as if for the first time, things they have known intuitively all their lives: how people with diabetes being human beings, not machines, require a different way of engagement.
And it is sad that this more empathetic way of working has all but been trained out of health professionals in their medical education. And, it is reckless that safety, trust, listening and partnership’s ability to drive behavior is all but overlooked in our pressurized, standardized health system.
Wednesday, November 15th I worked with almost 100 diabetes nurses, educators, researchers and physical therapists at the Region Steno National Konference in Copenhagen. I had them practice beginning a conversation from a solution-focused perspective rather than a coping perspective.
Health professionals typically find it difficult to start a dialogue looking for what a person with diabetes is doing well; it requires a new way of seeing and developing a new muscle. They, like other providers I’ve trained, also found it hard, and eye-opening
I also had them work in pairs listening for and then sharing the strengths they heard in their partner after she had told a particular story. They were struck by how close you can become to someone you don’t know in a matter of minutes, just by listening with your whole being, listening empathetically. How valuable this would be working with their patients.
On the Thursday I ran another workshop, this one at Steno and gave a keynote presentation on the theme of the previous day’s conference – Patient Involvement. My own view is that pulling patients into the medical world asking them to take on greater responsibility will not activate them more in their self-care.
We must have providers step into their patient’s world – to see how they live, learn about their challenges and resources, and meet them where they are. That is the connection through which people feel that they are not alone and become more confident, able and desirious to take better care of themselves.
We should be changing Patient Involvement to Provider Involvement.
I recited a quote during my keynote that when I first read it spoke completely to this idea. It was in an article by MD Atul Gawande, a surgeon at Brigham Women’s Hospital in Boston and Professor Harvard School of Public Health.
“In the 1990’s we replaced medical paternalism with the belief that we should activate patients by giving them options. But in the real world they ask us, “What would you do?” Because you are the expert, you still know better. This is for you to decide we say. And that is when people feel completely abandoned.”
Gawande goes on to say that palliative care clinicians also offer patients options and then they do something more. They ask, ‘What matters to you?’ And then they do something more, they listen.
And this is when patients feel connection and capability, two powerful motivational forces.
It is difficult to experience, myself, and to watch people with chronic illness suffering. In part because many providers lack the training and understanding how to effectively treat people with chronic illness. It is also tragic to see providers suffer from burnout and frustration, and leave the profession because they lack these skills.
This is why every time I get to change this landscape, to strengthen providers’ skills and the bond between patient and provider, I know I am just where I’m meant to be. How tremendous this time it turned out to be Copenhagen.
Photo by Mathias Løvgreen Bojesen