Category Archives: Doctor-Patient Relationship

Pitfalls Of Forgetting To Heal The Whole Person

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Pitfalls of Forgetting To Heal The Whole Person

In this blog, we are unwrapping the problems and pitfalls with forgetting to heal the whole person in an effort to establish true and effective wellness. If I had a nickel for every time I heard the words “specialty” or “specialize” in the healthcare field, I would be a very wealthy woman.

These are among the latest buzzwords and for good reason. Given the increased competition and expansion of healthcare options, specialization – even among “natural” or “alternative” health care providers—has emerged as the way to stand out in today’s consumerist economy.

Thanks to a combination of the Internet, increased communication, and a fast-paced economy, competing for the health consumer is only expected to become more and more commonplace in the decade. What is getting abandoned in the clamor to remain competitive as a health provider in either the allopathic or alternative fields is the quality of care.

What once distinguished “alternative” health care providers—mindful and respectful listening to the individual and being present in a way that addressed their needs as a whole person—has gradually been replaced by practicing or promoting the specialty that we have been trained and are experts at.

Critics of allopathic medicine have for a long time pointed to the specialization and fragmentation of health care services as the “demon” preventing the creation of an integrated, whole person health care system. Yet we see alternatives to allopathic medicine being practiced in an identically fragmented, specialized way.

The applications of nutrition, herbs, energy healing, body alignment, yoga, meditation, aromatherapy, and so forth, are primarily offered to the consumer without an integral whole picture of how healing takes place. Specifically, how our body functions as an integrated, homeostatic living being and how the specialty sciences that we call “alternative healing modalities” enhance or assist the function of our overall health on a physical, emotional, nutritional, environmental or spiritual level. The modalities of alternative care are now being offered in the same way medical specialties have been over for years; now, we just have more items on the menu to choose from.

It is also concerning is that alternative health care practitioners seem no better educated in integrated anatomy and physiology than most allopathic practitioners. One of the legitimate criticisms of alternative health care is the lack of evidence-based knowledge on the part of the practitioner to explain the effective outcomes from their application.

Alternative practitioners, like their allopathic counterpart who focuses on prescription writing as a cure, are woefully uneducated in the evidence-based sciences of human anatomy and physiology as well as lacking an authentic education and understanding in whole person science.

When I opened my practice in the early 1970’s the alternative practitioner was often seen by the suffering individual who sought their assistance as “an angel of mercy.” Today, it’s quite a different story. It is a sad testimony to the popularity of alternative health care that in the dawn of the 21st century people are more confused, less informed and even less aware of how their bodies work and how to take care of themselves over their lifetime than they were thirty years ago! Still too many are forgetting to heal the whole person.

Today I repeatedly overhear people confiding that they are disappointed with the alternative health care profession, and feel that there is the same focus on selling product or treatment plans as there has been in the medical practices they used to turn to. No longer do alternative practitioners spend the time they once did explaining and demystifying the process of disease and the cause and effect of where it comes from, but rather are busy selling the latest product of their trade or re-scheduling people for their next ten visits of care.

Economic success has come to alternative health care and with it the same issues that have plagued the practice of allopathic medicine for many years. Success is a strange bedfellow. If we lose the very essence that crafted our field then we have lost our personal and professional integrity.

The philosophical foundation of alternative health care is the knowledge and ability to address the whole person rather than just one isolated aspect of health. The five aspects of health include the physical, environmental, spiritual, nutritional and emotional. The specialization of alternative health care attacks the very core of this practice.

Modern practitioners are continuously specializing in physical areas of the body or specific conditions or diseases such as chronic fatigue syndrome or environmental allergies. This specialization is creating isolation where practitioners are failing to treat the whole person. Countless studies have shown the effectiveness of treating the whole person in a relationship-centered, education-focused model of practice.

In our roles, whether as allopathic, alternative or holistic health practitioners, whole health coaches, or holistic nurses, we must establish and promote a practice of treating the entire person and addressing the bigger picture of their illness or presentation. Given rapidly rising chronic diseases such as diabetes and obesity, it is our duty to remain true to this integral approach to healing and serve our patients in the way they want and need us to.

I encourage this initiative to health practitioners across the country: Fight specialization and favor treating the Whole Person. It is only with such an approach that we can begin to solve that which ails us.

NIWH Whole Health Educators™ Empowering Better Health

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It’s no secret that we Americans have reached an all-time level of being “unhealthy,” thanks to an ever-increasing stress-filled lifestyle. Despite widespread campaigns aimed at helping people stop smoking, eat better and exercise, the vast majority of Americans does not get regular exercise and are not eating enough fruits and vegetables. There is a clear need to empower others to take control of their health and wellness.

There has been an explosion in obesity that is cited as high as 63%, along with climbing rates of diabetes, heart disease, cancer and other diseases associated with lifestyle and behavior choices. As far back as 1996, Harvard Medical School published a 7-year study which confirms up to 70% of all cancer, heart disease, stroke and mature onset diabetes are preventable with lifestyle and behavior changes. And yet, the health of the wealthiest nation in the world continues to decline. These factors underline the importance of a Whole Person based accredited health coaching program.

A Need For Real Health Education

Core factors for this epidemic amongst Americans can be found in a recent government study. The Institute of Medicine published a major study identifying that ninety million Americans are “health illiterate.” This does not mean, in this internet dominant society, that people do not have access to or are not receiving enough health and wellness information. It means that the majority of us do not know how to interpret or use the health information we receive to control or improve our health and wellness or prevent chronic disease. This reveals the need for more Whole Health Educators (TM), Advocates, and Coaches to bridge the gap.

Think of the last time you read the results of a new study in a magazine and realized you did not know how to use that information to support or improve your health. In fact, data presented to the American College of Health Care Executives identifies “lack of information as the number one root cause of death.” Yet, experts like Susan Edgman-Levatin, Executive Director, John D. Stoeckle Center for Primary Care Innovation at Massachusetts General Hospital, acknowledges “It’s no secret that traditional methods of patient education are hopelessly ineffective.”

NIWH Has An Answer

Addressing this problem, as far back as 1977, the National Institute of Whole Health in Boston, Massachusetts, in cooperation with physicians, nurses and online health educators, began research and development on an extraordinary, whole-person focused model of health education. The product of these 30 years of development in Boston area hospitals, the Whole Health Education® accredited health program, has today found its way into the medical mainstream.

These specialized health educators, Whole Health Educators ™, are uniquely trained to maintain a respectful presence and mindful listening skills as well as evidence-based, integrated health sciences to demystify for their clients the five major factors of health that influence how well we are or how sick we become. By providing “the big picture of health”®, an integrated understanding of how these five aspects can cause health or disease, the patient or client can possess the knowledge and tools to make necessary lifestyle changes and behavioral choices that are personally right for them. Identifying the root cause and effect of a chronic condition can free an individual to make changes they may not have previously considered.

You Are The Solution

There’s something that students and alumni of NIWH’s accredited health program have already discovered. If you are looking for work with purpose and integrity and are a health care professional, or entry-level candidate, who desires to serve others by providing evidence-based health information, and a natural, spiritual outlook on healing, this program may be of interest to you. NIWH offers Holistic Nurse Certification and Health Coach Certification. Program are offered through distance learning as well as optional in-person weekend classes, conducted at a Harvard affiliate hospital in the Boston area, which includes nationally recognized health experts and outstanding core facility members. For more information visit www.niwh.org or call 888-354-HEAL (4325)

Join the conversation. If you enjoyed this article, be sure to follow NIWH on Facebook and Twitter for regular updates filled with accredited health program information for holistic nurses and whole health coaches or advocates.

What’s The Biggest Problem In Healthcare Today?

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healthcare

During the National HealthPolicy Conference held in Washington, D.C., members of the Agency for Healthcare Research and Policy agreed that there is an urgent need for research focusing on the doctor-patient relationship. This is the key to addressing  the current crisis of patient dissatisfaction, medical-error, malpractice claims, and physician burnout.  Clearly, there is a need for improved communication throughout the healthcare system.

The Problem:

Patients are not happy, doctors and medical teams are not happy, and the health care system is struggling to adapt measures to turn the tide of this growing problem. The Institute for HealthCare Communication (IHC) report regarding poor doctor-patient communication revealed the following:

  • Research conducted during the 10 year period of 1995-2005 demonstrated that ineffective team communication was the root cause for nearly 66 percent of all medical errors.
  • When healthcare team members do not communicate effectively, patient care often suffers.
  • Medical error vulnerability is increased when healthcare team members are under stress, in high-task situations, or not communicating clearly or effectively.

The research from the IHC reports cites that 50% of all malpractice is the result of poor communication between doctor and patient.

The IHC report states: “Research evidence indicates that there are strong positive relationships between a healthcare team member’s communication skills and a patient’s capacity to follow through with medical recommendations, self-manage a chronic medical condition, and adopt preventive health behaviors. Studies conducted during the past three decades show that the clinician’s ability to explain, listen and empathize can have a profound effect on biological and functional health outcomes as well as patient satisfaction and experience of care.”

It continues toward an alarming statement: “Extensive research has shown that no matter how knowledgeable a clinician might be, if he or she is not able to open good communication with the patient, he or she may be of no help.”

Solutions

While the addition of nurse health coaches and our health advocate program have been viewed by some as a solution to the communication problem, the relationship between the physician or primary care provider and the patient cannot be corrected by these additional team members. In fact, not addressing the underlying cause of doctor-patient discomfort may even increase the distrust and discomfort the patient experiences with their doctor or primary care provider.

As physicians, physician assistants, nurse practitioners, and health advocacy program members are the diagnostic experts in our medical care system, ensuring the communication between these providers and their patients is critical.

A pilot study, conducted through Central Michigan University (CMU) on the effects of a communication model, Behavior Engagement with Pure Presence, on patient and physician satisfaction has just concluded. The study was funded by Blue Cross and Blue Shield Foundation of Michigan.

The Primary Investigator (P.I.) of this study, Dr. Christine Clipper, wanted to test the Behavioral Engagement model by including renowned endocrinologist Dr. Opada Alzohaili, who was trained in the model’s communication skills and previously earned high patient satisfaction survey ratings. Dr. Alzohaili’s post-pilot patient satisfaction scores were significant, revealing 100% improvement on all measures of patient perception of relational empathy duringtheir encounter with the doctor, in contrast to his pre-pilot patient satisfaction scores.

Dr. Clipper’s research data demonstrated that Behavioral Engagement with Pure Presence has “…a psychological effect on the patient’s perception of the patient-provider relationship. The patient perception of relational empathy with their doctor increased through improved provider communication skills through applying the Behavioral Engagement model.”

For more whole health discussions like this, listen to my weekly radio show Living Above The Drama available on iHeartRadio.

Doctors Taking Control of Healthcare

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Doctors Taking Back Control Of Healthcare

For those us of old enough to remember Marcus Welby, MD and Dr. Kildare, the beloved TV docs we grew up with, we also remember a time when physicians ran healthcare. They set policy, budgets, insurance coverage guidelines and pretty much, back then, “everything healthcare” was directed by the doctors.

The insurance carriers, growing tired of paying for unnecessary surgery, warned the physician groups who ran the show that if they did not clean up the medical abuses taking place, the insurance industry would take away their decision making by enforced second opinions and limit paying for procedures that were being unnecessarily performed. Back in the 1970’s, there were millions of hysterectomies. Of these, 66% were deemed “unnecessary” by what has become the Medical Review Board watchdog.

Now in the U.K., to quote an article from English.news.cn, “The new British coalition government revealed on Friday that it planned to put doctors in charge of funding for frontline services in England’s National Health Service (NHS), in a change hailed as the biggest in 60 years.”

This is big! If this were to be enacted in the U.S., we could see a return of physician driven healthcare that is provided, determined and distributed by the same medical type of physician groups that were unable to police themselves a mere 30 years after the establishment of the American Medical Association and the mainstreaming of the pharmaceutical industry.

Granted, we have in place excellent watchdogs peer review boards and medical review requirements, but this works because of the lack of conflict of interest with the way these structures have been put in place.

The healthcare reform bill has yet to flex its muscles and most of us feel pretty much in the dark about what we can expect. No surprise since an overwhelming majority of politicos who voted on the bill had little to no idea what the bill contained!

The issues we see with today’s healthcare delivery simply reinforce the Whole Health vision of taking control of your body, preventing disease with common sense health hygiene and limiting the use of acute care medicine we as Americans are blessed to have available to us. Every day the news contains articles identifying the long-term use of even over the counter medications and caution us to realize we cannot repeatedly put these chemicals into our bodies and not experience consequences.

Chronic disease, which is the bulk of what is treated in healthcare today, is preventable and cost effective. Let’s create our own healthcare reform with self-directed whole person care – that means taking care of ourselves with consideration to all 5 aspects of health. In advocating this type of care through patient education, we all move toward living well and living long.

For more whole health discussions, listen to Dr. Georgianna Donadio’s radio show Living Above The Drama.

How Essential Is Doctor-Patient Communication To Whole Health?

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Nurse-Patient Communication

At the National Health Policy Conference held in Washington, D.C., members of the Agency for Healthcare Research and Policy agreed that the need for research focusing on the doctor-patient relationship was urgent in order to address the current crisis of patient dissatisfaction, medical-error, malpractice claims and physician burnout. Communication between the patient and all practitioners or  caregivers is thus an essential component of any whole health approach.

Patients are not happy, doctors and medical teams are not happy, and the health care system is struggling to adapt measures to turn the tide of this growing problem. The 2012 Institute for HealthCare Communication (IHC) report regarding research on the impact of poor communication revealed the following:

  • Research conducted during the 10 year period of 1995-2005 has demonstrated that ineffective team communication is the root cause for nearly 66 percent of all medical errors during that period.
  • This means that when healthcare team members do not communicate effectively, patient care often suffers.
  • Further, medical error vulnerability is increased when healthcare team members are under stress, are in high-task situations, and when they are not communicating clearly or effectively.

The research from the IHC reports cites that 50% of all malpractice is the result of poor communication between doctor and patient.

The IHC report states: “Research evidence indicates that there are strong positive relationships between a healthcare team member’s communication skills and a patient’s capacity to follow through with medical recommendations, self-manage a chronic medical condition, and adopt preventive health behaviors. Studies conducted during the past three decades show that the clinician’s ability to explain, listen and empathize can have a profound effect on biological and functional health outcomes as well as patient satisfaction and experience of care.”

IHC goes on to make an alarming statement that “Extensive research has shown that no matter how knowledgeable a clinician might be, if he or she is not able to open good communication with the patient, he or she may be of no help.”

And, while the addition of nurse health coaches to the medical team has been viewed by some as a solution to the communication problem, the relationship between the physician or primary care provider and the patient cannot be corrected by these additional team members. In fact, not addressing the underlying cause of doctor-patient discomfort may even increase the distrust and discomfort the patient experiences with their doctor or primary care provider.

As physicians, physician assistants and nurse practitioners are the diagnostic experts in our medical care system, ensuring the communication between these providers and their patients is critical, as research data demonstrates.

A recent pilot study, conducted through Central Michigan University (CMU), on the effects of a communication model, Behavior Engagement with Pure Presence, on patient and physician satisfaction has just concluded, and will be published shortly. The study was funded by Blue Cross and Blue Shield Foundation of Michigan.

The Primary Investigator (P.I.) of this study, Dr. Christine Clipper, wanted to thoroughly test the Behavioral Engagement model by including renowned endocrinologist, Dr. Opada Alzohaili, who was trained in the model’s communication skills and had previously earned high patient satisfaction survey ratings. Dr. Alzohaili’s post-pilot patient satisfaction scores were significant, revealing 100% improvement on all measures of patient perception of relational empathy during their encounter with the doctor, in contrast to his pre-pilot patient satisfaction scores.

Dr. Clipper’s research data demonstrated that Behavioral Engagement with Pure Presence has “…a psychological effect on the patient’s perception of the patient-provider relationship. The patient perception of relational empathy with their doctor increased through improved provider communication skills through applying the Behavioral Engagement model.”

Further research on the application of the model includes a pilot study on the Behavioral Engagement model in Electronic Medical Record Communication, funded by the U.S. Department of Health and Human Services/ MI Dept. of Community Health;
and a randomized controlled clinical trial study with funding from major national health care organizations.

For more whole health discussions like this, listen to Dr. Georgianna Donadio’s radio show Living Above The Drama.

 

Six Immediate Steps To Improve Your Relationships

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Six Immediate Steps To Improve Your Relationships

Making your relationships more fulfilling for you as well as for the important people in your life is easier than you might think. Most of us simply forget what makes a good relationship, yet we know what it feels like when one of our relationships isn’t going well. Often, improving any aspect of your life is a matter of being reminded what the tried and true behaviors are that create happy relationships. Here are six easy-to-remember and even easier-to-do steps you can take right now to improve your friendships, family dynamics and even interactions with co-workers:

1. Respect Everyone

Respecting someone means to literally accept them for who they are and how they choose to think, feel and live. We cannot change others, and it is futile and even presumptuous of us to try. By accepting others and meeting them in a respectful way, we save ourselves needless frustration. No one wants to be told who to be or how to live; and the sooner you apply this principal, the sooner you improve your relationships.

2. Practice Kindness

Kindness is one of the most attractive qualities in anyone. Even more attractive is when a person thinks and feels that all others are worthy of their consideration and kindness and treats others with mutuality and compassion. People notice kindness and know when someone is caring. This is easy to do if you treat other people the way you would treat anyone you truly care about.

3. Be Happy For Others

In the highly competitive, often dog-eat-dog environments many of us work and live in, we can develop an attitude that if “we don’t have ours” than “no one else should have his.” This is an unhealthy and unsuccessful attitude that doesn’t allow us to celebrate for others and invite them into celebrating for us when we have success or an achievement. Good wishes toward others result in good wishes for us.

4. Release Resentments

When we hold onto anger or resentment toward others, we end up doing more harm to ourselves than to them. Anger and resentment make us sick and chains us to the events or circumstances that hurt us. This does not allow us to move on in life, and it lessens the love and kindness we can be experiencing and sharing with others. It leaves us in turmoil about something in the past.

5. Do The Small Things

Think back to your most tender and memorable moments with the important people in your life. You will probably find that those moments were filled not with expensive, larger-than-life gifts, events or experiences, but rather with small, meaningful gifts, gestures and shared experiences. While you cannot do special things for everyone in your life, the people who are most important will really appreciate it if you show them how important they are to you with the small things that mean so much.

6. Follow the Golden Rule

There is a saying that we should never expect others to give us what we are not willing to give to them. The Golden Rule is a simple one: Give to others what you want the most for yourself. If you want to be loved, love others. If you want success, than provide service or value for others. This is an easy and simple rule and best of all, it works.

For more whole health discussions like this, listen to my weekly radio show Living Above The Drama available on iHeartRadio.

 

Decoding Body Language: The Messages We Send And Receive

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What is also understood is that there are “tells,” or neurological expressions of these withheld, nonverbal communications happening inside our brains. Even though we may not consciously or intentionally express verbally or physically how we feel, our brain/body connection does express these thoughts and feelings in nonverbal ways. These nonverbal ways are the “tells” that police and other professionals use to decide if someone is withholding information. This skill usually relies on instinct, but it might be wise to include such a information in today’s health coach certification programs to assist nurses in treating their patient's ailments holistically and effectively.

Relationship Impact

Many studies have been done on the subject of body language and nonverbal communication. Most of these findings agree that it is important for all of us to become aware of how our physical and verbal or nonverbal behavior impacts others, especially those who spend the most time in our environment.

Nonverbal communication can often cause one individual in a relationship to become upset if he feels he is seeing or interpreting nonverbal actions by his partner as rejection or disinterest. Often, before a relationship ends, one partner suspects the relationship is in trouble because of a lack of eye contact or verbal communication or because of hostile body language, such as the crossing of arms or legs in response to communication attempts.

Thoughts, Feelings, and Your Body

There is a science to nonverbal communication interpretation, as well as a science to understanding the best way to express our feelings. The way we do that can result in a positive or negative outcome. The science is directly related to neurological and neurotransmitter connections between thoughts and feelings in the brain and their communication to the muscles and nerves in the rest of our body.

Healthy Applications

Body language communications are both sent and received. We should become more mindful of the cues others are sharing and learn to read them more effectively because the information can be surprisingly vital. In my consulting practice, I see this all the time. A patient’s body language often conveys information they are leaving out, whether due to timidness, embarrassment, or lack of conscious. Nonetheless, nonverbal communication can alert to a need to press further for more clues about the presenting complaint.

Interpreting a patient’s or loved one’s body language can require close observation, something worth practicing whether you are a practicing nurse, an individual pursing a health coach certification, or simply a person hoping to improve your communication skills and your relationships.

In closing, we should all make an effort to monitor the nonverbal communication we are sharing in both our professional and personal lives. These cues can also offer hints to the real struggles lying beneath the surface.

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