When patients complain about their health—but won’t take care of themselves: Tips for end-of-year health check-ins
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After years in both critical care nursing and conflict management, I've learned that one of the hardest skills for healthcare professionals to master is recognizing where our accountability ends and patient autonomy begins.
—Kimberly Best, RN, MA
You have to meet people where they're at in a compassionate way that's non-judgmental.
—Aaron Hartman, MD
Getting patients to take their own health seriously is no small feat. In a world where fast food is ubiquitous and endless work hours mean many people are sitting throughout most of their day, it’s easier and easier for people to become sedentary and fall into unhealthy patterns.
Poor nutrition and a lack of physical activity increase the risk of obesity, heart disease, depression, type 2 diabetes, and cancer. [] But how do you get patients to understand that these risks are real—and not just an abstract concept?
Related: How to prioritize self-care without compromising patient careAdvice from the experts
As your patients’ year-end check-ins pile up, experts offer some insights on how to talk to them about making healthy changes.
Jordan Weiner, MD, an otolaryngologist and sleep apnea specialist, explains: “In medicine, sometimes when we talk to patients about modifiable risk factors, from the patient’s perspective, it can seem very theoretical,” he says. “Since they really don’t fully understand why we are talking about those behaviors, it comes off like nagging. The key is helping them to see it from our perspective. We are trying to help them live a healthier and hopefully longer life.”
Aaron Hartman, MD, a functional medicine practitioner, says he learned how to work with patients who are reluctant to make changes early in his career treating smokers.
“Back then, I was told that the average smoker had to be recommended by their doctor to quit smoking seven times before they'd even attempt it once,” Dr. Hartman says. “What I learned early on is I had to have a relationship in order to have those seven encounters where I could talk with them and say, ‘Hey, you should quit smoking.’”
But beyond spending time with patients, he says it’s how he communicated with them that matters.
“Being mean, arrogant, conceited, authoritarian, or came across the wrong way? I would never get to that seventh time. You have to meet people where they're at in a compassionate way that's non-judgmental. Using humor and being whimsical always amplifies the fact that they know you care. And that's the key. The person you're working with has to know you care," Dr. Hartman syas.
Sometimes, however, getting patients to make better choices is not something you can force.
“After years in both critical care nursing and conflict management,” says Kimberly Best, RN, MA, “I've learned that one of the hardest skills for healthcare professionals to master is recognizing where our accountability ends and patient autonomy begins."
Related: ‘I’m going home’: Discharging a patient against medical adviceYou can lead a horse to water, but you can’t always make them drink
“The truth is, we can't want someone's health more than they want it themselves," Best says. "Our job is to make sure they truly understand the consequences of their choices, to answer their questions honestly, and to document thoroughly. But the choice? That belongs to them, not us."
Best gives an example of the kind of language she uses with her patients: “I can see this is a difficult decision. I want to make sure you understand what might happen if you continue this way, but I also respect that this is your choice to make. I'm always here if you have questions or if you decide you want to try something different."
In the end, she says it’s not about convincing patients or guilting them—it’s about being clear and opening the door toward better choices.
Want to learn more about how to help your patients? The AMA’s Ed Hub portal, for instance, includes training programs from the American College of Lifestyle Medicine. []