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The thing that really sold me on patient self management is that
it allows you to move from being an adversary of the
patient in a way to putting your chairs
together to be common problem solvers.
And this comes up so often because so much of the work that
we do as health care providers is to help
patients make behavior changes.
Taking the self management role allows you to have a whole
different look at how you work with your patients and how you
come at solutions that will help improve their health.
I was impressed when I came here with the burden that CF presents
to people and their families and I do believe that that's why
self management support is critical because we need to help
people navigate through that and still be optimistic
and hopeful and have a life.
If it doesn't get done at home, it's not going to get done and
then we'll do a rescue when they come to the hospital.
They come into the clinic sick, we put them in the
hospital for a couple of weeks.
We do all this intensive care.
We get them back to their baseline.
But to stay at the baseline or to improve,
if they don't do it at home, it doesn't happen.
If we tell them what to do by the time they leave the health
center, they forget what we tell them and
they don't follow through.
With self management support we take small steps.
It's a process and we do actually follow patients,
meaning we encourage them to call us,
to tell us what their small little aha moments are.
And they do do that and they are very proud
of their little moments.
And so we walk along side them through this process.
This is very important for me because not only am I able to
communicate with the patient but also better
communicating with the provider.
Prior to this program you just saw the patient and just gave
the chart to the provider but now we have to talk about what's
going on with the patient, we have to talk about the process,
we have to talk about the plan.
One of the things that we found when we started doing patient
self management is that it
improved communication among everyone.
Among the patients, the nurses, the front desk staff,
the clinical team as well as patient to provider.
So that we were working better with our colleagues in addition
to working better with our patients.
Most long-term primary care practices are about chronic care
management and this is the kind of thing, the team approach,
self management techniques, the collaboration between a doctor
and a patient, a provider and a patient,
this is something that is exactly what we do
all day long every day.
To work on this model means that you're going to do a better job.
You're going to give better care.
You're going to have patients who are more satisfied.
And you are going to feel like you do more in less time.
So can you think of something you'd like to do?
They're in control actually all the time anyway.
So why not let them manage their own care at home because you're
not going to be there and it's not your goal,
it's the patient's goal.
They have to be willing to make a difference for themselves.
The whole idea of self management when you're talking
about a chronic illness like *** is immensely important because
what good is a pill if the patient won't take it?
This chronic illness really depends on the patient's buy-in
to target the behaviors that we are trying to change.
How are you feeling?
Doing okay?
Any new problems since I saw you last?
I learned so much more about my patients when
I started using this approach.
Things that I never knew before
because I wasn't asking the right questions.
The information that I learned from my patients when I asked
open-ended questions when I asked them what was most
important to them about their health gave me information that
I could use to help them work on their health care problems.
Letting the patient lead the way is important.
Then when they see success, it's rewarding for both of us.
Yes, I listened to them, to see what their needs were and they
did it and now they feel better so we are both winning.
We've had some successes where patients have said to us please
don't go back to the old way, the traditional way.
We like that everyone is involved in our care.
That's a wonderful thing to hear from patients.
They see that it's a positive team approach.
People think it's going to take more time to practice self
management and the reality is that it takes less time.
We have happier clients.
We have less phone calls...
It's an amazing a relief of burden on our system.
It's totally changed my view about practicing medicine
and coming to work.
It just makes it so much easier and more joyful.
People are happy I think.
And I feel happy after the day is done.