In classic scientific understatement, U.K. researchers Drs. Michael Kelly and Mary Barker observed that “most efforts to change health behaviours have had limited success.”(1)
No kidding. Right now, even as you read this, academic researchers all over the globe are applying for (and getting) grant funding to embark on yet another new study examining smokers who don’t quit, couch potatoes who don’t get off the couch, or overweight people who don’t lose weight. I can’t be 100% certain, of course, but I’m betting my next squirt of nitro spray that these studies will no doubt conclude that, yes indeed, those people do need to change their behaviour, and “further study is required”.Continue reading “Six ways NOT to motivate patients to change”→
I am clueless about many things. As in the definition: “Lacking understanding or knowledge.” As in the sentence: “I have no clue!” As in the 20+ years I spent living with a research scientist and enduring mind-numbingly torturous dinner party conversations about zinc and copper sediment in the Fraser River estuary.
Way back in 1847, the American Medical Association panel on ethics decreed that “the patient should obey the physician.”
There may very well be physicians today – in the era of empowered patients and patient-centred care and those darned Medical Googlers – who glance nostalgically backwards at those good old days.
Let’s consider, for example, the simple clinical interaction of prescribing medication. If you reliably take the daily meds that your doctor has prescribed for your high blood pressure, you’ll feel fine. But if you stop taking your medication, you’ll still feel fine. At least, until you suffer a stroke or heart attack or any number of consequences that have been linked to untreated hypertension.
Those who do obediently take their meds are what doctors call “compliant”. And, oh. Have I mentioned how much many patients like me hate that word?
I’ve been on an adventure recently to a magical, faraway place. It was my second visit to the world-famous Mayo Clinic in beautiful downtown Rochester, Minnesota. My first trip there was exactly seven years ago as a freshly-diagnosed heart attack survivor. I had applied (and was accepted) to attend the annualWomenHeart Science and Leadership Symposium for Women With Heart Diseaseat Mayo Clinic – the first Canadian ever invited to attend. This is a training program that arms its graduates with the knowledge, skills and (most of all) Mayo’s street cred to help us become community educators when we go back to our hometowns.
Thus, a circle that began with me sitting in a 2008 training audience was completed as I became one of the presenters onstage in front of an audience of cardiologists at a Mayo medical conference on women’s heart disease. (Thank you Drs. Hayes, Mulvagh and Gulati for your persistent invitations!) But long before I took the stage last weekend, I’d been invited to come to Rochester a day earlier to meet with some pretty amazing Mayo staff. Continue reading “How Minimally Disruptive Medicine is happily disrupting health care”→
I think I’ve seen just about every “healthy lifestyle” informational brochure out there. You’ve seen them, too: Eat better! Lose Weight! Quit Smoking! Get More Exercise! BlahBlahBlah! None that I’ve found so far, however, mention anything that we don’t already know. Behaviour change is notoriously challenging – otherwise we’d all be doing it already. It seems to me that the issue is not so much about raising awareness of something that isn’t well understood (Really? Smoking is bad for us?) but more about presenting information in a way that seeks to somehow meaningfully interact with the reader.