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.
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WIHI: Workplace Violence in Health Care Can't Be the Norm
WIHI: Greater Satisfaction, Outcomes, and Savings With Self-Administered Care
WIHI: How to Fail Forward (Quickly) on the Road to Population Health
WIHI: How to Beat the Boring Aspects of QI
WIHI: The Digital Transformation: How Technology Is Helping (and Hurting) Health Care
WIHI: Seven Popular Improvement Tools: How (and When) to Use Them
WIHI: The High Stakes of Health Care Policy
WIHI: Creating Age-Friendly Health Systems
WIHI: Who's Your Health Care Proxy?
WIHI: What We're Learning about Patients with Complex Needs
WIHI: The Right Care, Right Setting, and Right Time of Hospital Flow
WIHI: Claiming the Edge with Quality Improvement in Communities
WIHI: Practicing Respect and Preventing Harm
WIHI: The Next Wave of Patient Safety
WIHI: Improving the Rate of Recommended Care: Looking Back and Looking Ahead
WIHI: Moving Upstream to Address the Quadruple Aim
WIHI: Measures That Matter: Whole System Measures 2.0
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