A pediatrician explains how to make patient engagement a partnership not a dictatorship

question-markMany of the patient engagement discussions I hear tend to be focused on how to get patients to do what they’re told  and how to get physicians to listen to their patients. So it was great to hear pediatrician Dr. Ivor Horn from Children’s National Medical Center bridge the gap in a panel discussion at the ENGAGE conference by talking about how she views engagement as a partnership.

Physicians need to find ways to encourage patients to ask questions about their care to they can be better patients. If providers can establish that rapport, patients and caregivers will be more likely to speak up when they don’t understand something or don’t agree with them. Informed patients make a better doctor, basically.

To illustrate the point, Horn recounted an asthma clinic education program that she helped develop for families to discourage them from going straight to the emergency room that led to an unforeseen problem. Although the hospital reduced the number of people going to the ER, patients were not going to their primary care physician either. Or they would go but they weren’t able to have an effective conversation. The solution was to set up an intervention.

The intervention walked through families’ healthcare visits. It turned out that important information was getting lost or forgotten. So to resolve the issue the information communicated in the visit was put on a mobile phone so families could take it with them and refer to it


For her part Horn said she encourages patients to ask questions, “…even if I have my hand on the doorknob” as she is walking out. “If we can empower patients to engage with doctors, then doctors can engage them back,” said Horn.

The reluctance to ask questions is a widespread problem across healthcare. Ivor said a lot of her patients don’t feel like they have the right to ask her questions. With elderly patients, it’s a generational issue since they were frequently brought up not to question the doctor. “Part of my job as a provider is saying to patients: ‘It’s OK if you ask me questions.'”

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