Welcome. When it comes to patient communication and patient engagement there is conventional wisdom...and then there is Mind the Gap. Here you will find evidence-based insights, original research, thought-provoking content and innovative, patient-centered communication solution for health care providers.
Steve Wilkins, MPH, Founder & CEO, Mind the Gap & Adopt One! Challenge
Patient Communication And Engagement Portal
Featured Mind The Gap Blog Posts
Quotes, Facts & Definitions
"How well patients follow their doctor’s orders is significantly related to the communication skills of their physicians."
Robin DiMatteo, Distinguished Professor of Psychology. University of California, Riverside
Patients And Their Traditional Passive Sick Role
"The traditional patient role is to be compliant, passive, and trusting. Many of the behaviors expected of consumers are antithetical to this traditional role, requiring them to question or challenge medical authority."
Hibbard, J. Medical Care Research & Review. 2009.
The Importance Of Communications
“I don’t think you can overstate the importance of communication in clinical care. Even with devices, robotics, genomics and personalized care, it all rests, and depends on, clear communication.”
Dr. Wendy Sue Swanson, MD, MBE, FAAP
ACOs Need to Focus On Relationships Not Transactions
“The problem ACOs must overcome is they aren’t top of mind at the point of decision for their patients. Is this any surprise? I hear more frequently from my vet than my MD.”
Dave Chase., WebMD. Forbes. 2010.
"If you will just listen to patients. they will tell you what's wrong with them. And if you will listen a little longer, they will tell you what to do about it."
Tom Brower. MD
Patients Don't Sue Doctors They Like
"Patients sue when their feelings are ignored or when they are angered by lack of genuine concern for their welfare. . . . Though it provides no guarantee, a sound physician-patient relationship is a powerful antidote to frivolous lawsuits.”
Abraham Verghese, MD. Hard Cures. 2004.
Patients' Not Getting What They Need
"It could really just be my lack of communication skills or possibly my inability to speak up, but every time I go [to the doctor], I feel nothing happened, and when I walk out of the door, I’m not really armed with more knowledge of my health than when I walked in...”
"As physicians, we've become adept at going on autopilot within a few seconds. We go into automatic thinking about what diagnosis the patient has and stop listening."
Terry Stein, MD, Kaiser Permanente, Co-Creator of the Four Habits Model
Definition Of Patient-Centered Communication
"Seeks to increase health care providers' understanding of patients' individual needs, perspectives, and values: to give patients the information they need to participate in their care: and to build trust and understanding."
Levinson, W. et al. Health Affairs. 2010.
Definition Of Empathy
"Empathy is the ability to understand another's experience, to communicate and confirm that understanding with the other person and to then act in a helpful manner."
Dr. Robert Buckman, Princess Margaret Hospital and the Faculty of Medicine, University of Toronto
"Care coordination currently is left mostly to the patient or his or her family...that's a task best left to primary-care doctors. Right now, coordination is horrible in this country for the most part."
Dr. Ann O'Malley, a researcher with the Center for Studying Health System Change
“The art of medicine is intricately tied to the art of communication”
Teutsch C. Medical Clinics of North America 2003
"Without patient-centered communication, patients and clients are taken out of the loop, leaving practitioners to assume or guess their needs and preferences. In such a situation, [patient] autonomy is simply impossible."
Improving Communication—Improving Care 2006. American Medical Association
"Factors that increase the likelihood of seeing a physician include serious illness worry, symptom duration, specific expectations, disability,and the presence of mental disorders."
Jackson, J. et al. Archives of Family Medicine 1999
Paternalistic Physician-Patient Communication
"These data show that there is still considerable paternalism in medical decision making, and the decisions we studied that are most physician driven are those typically made in a primary care, rather than a surgical, setting."
Barry, M. et al. JAMA Internal Medicine. 2013
"Patient engagement maybe the blockbuster drug of the century...but you still need a physician to prescribe it."
Steve Wilkins, Mind the Gap
Problem With Patient Satisfaction Surveys
Many patient satisfaction surveys mix treatment satisfaction items with communication skill items making it difficult to use these tools to provide concrete feedback on basic communication skills to physicians in a manner that could facilitate physician learning and possible behavior change. ."
Markoul, G. et al. Family medicine. 2010.
Meaningful Use & Patient Portals
Better Patient Experiences
Patient Medication Adherence
Better Patient Engagement
Barriers To Better Communication
What People Are Saying About Mind the Gap
Patient-centered communication rock star Steve Wilkins wrote a great piece on his blog this week: The 10 Commandments of Patient Engagement. In the post, Steve lists 10 actionable steps providers can take to more meaningfully engage with patients during a visit. I agree with every single one of them.
Wilkins' reasoning points to an issue at the heart of the confusion surrounding patient portals: vendors and providers have been developing technology for influencing patient behavior away from points of care without knowing how patients behave, regarding their health, in between visits.
The fact is that people each have different health beliefs and motivations that drive their health thinking and behavior, and a one-size-fits-all provider-centered approach doesn’t work.” Wilkins writes a blog on patient engagement called Mind the Gap.
Earlier this week, Steve Wilkins wrote a fascinating blog article contrasting the responses patients provide on satisfaction surveys and other published data. He suggests that there is a significant disconnect between what patients say in surveys and what happens in practice.
Mr. Wilkins is right. The most innovative, elegant mHealth app is never going replace a strong doctor-patient relationship.
If you are assuming a patient isn’t engaged, then chances are your mindset may be off. Stephen Wilkins, author of the Mind the Gap blog, has a great perspective on this. If you haven’t seen any of his writings, I suggest you check him out.
A great resource on the topic of patient and physician communications comes from Stephen Wilkins who blogs on @ Mind the Gap. For example, in a post of his last year he discussed the implications of poor doctor-patient relationships on medication adherence.