The 3 E's of Enhanced Health

“Social change is better achieved by being for something than against something. Growing up, I was part of a protest generation. We protested the war and stood in support of liberation struggles in Africa. Whenever we saw a problem, we were “against” it. It’s easy to think that by being against something you’re standing up for a cause, but if you want to have a greater impact, you need to ask yourself, ‘What do I stand for and what do I want to happen?’”¹ – Helene Gayle, MD, Care USA President and CEO

When I read this passage last week, I started thinking to myself, “How does this apply to health care, and specifically, to my daily interactions with patients? What do I stand for?” While it’s crucial to combat disease, for instance, to decrease or prevent complications from diabetes - from myocardial infarction to neuropathy - I would hope that I also am fighting for something positive as well, one patient at a time.

Here are 3 areas of focus that I’m for:

1. Education - Whether a medication, a procedure, or a test, I’m talking about explaining the risks and benefits in clear, jargon-free language, so that patients can be equipped as much as possible to make a well-informed decision that rings true for him/her. This type of education can also take the form of drawing out the natural history of the decline in insulin secretion in a simple graph on a sheet of paper, or a dry-erase board. It should not take a judgmental, fear-based angle.

2. Empowerment - Let the patient, in concert with his/her caregiver, friend, or the like, take ownership. What does she prefer? What are some of his goals? Encourage the patient, through a means such as motivational interviewing, to select one change to make between now and the next follow-up visit. Will the patient select decreasing portion sizes, quitting smoking, or checking SMBGs more consistently?

3. Engagement - If patients are inspired, enthused, and raring to go, then I feel that they’re on their way, no matter where they’ve been before - whether their A1c was 13, they were deeply lodged in denial about their diabetes, or they had developed complications. Patient buy-in can be elusive and difficult to secure, but ultimately, this is part of why I love what I do.

None of the above is easy. But, what in life that is worthwhile is? These motivations should all be fueled and supported by a foundation of hope. Or in other words, “let’s take this feedback you’re getting on your sugars and see how you can start to turn things around.”

            Please share your thoughts. What do you stand for? How would you explain your treatment philosophy?

References:

1. Segal GZ. Getting There: A Book of Mentors. New York: Harry N. Abrams; 2014: 184.