SRFP002: A Qualitative Analysis of Patient Perspectives on Low Value Healthcare and the Patient-Clinician Relationship
Kenan Michaels, BA; John Epling, MD, MSEd; Michelle Rockwell, PhD, RD
Kenan Michaels, BA; John Epling, MD, MSEd; Michelle Rockwell, PhD, RD
Thank you for your kind words Dr. Baumgardner!
Terrific poster and presentation. Thanks for your work.
Thank you Dr. Westfall! I appreciate your kind words!
As someone deeply interested in patient-provider communication, this was a fascinating read. I think this would be very reassuring to a lot of clinicians who might be hesitant to reduce LVC. We can certainly do a better job communicated exactly what LVC is to patients - nice presentation and I look forward to seeing more work in this area.
Thank you Dr. Bartlett for checking out my poster, your comment, and leadership with NAPCRG! I was very excited to be included this year. Completely agree that we should make patients more aware of LVC!
Very important Fascinating research question. I agree, next steps should include more foundational qualitative work on clinician- patient understanding of what constitutes low value, shared decision-making and setting patient oriented goals. Thanks for sharing your work here at NAPCRG. - Bill Phillips
Thank you Dr. Phillips for your comment and kind words. Was an honor to be included in this year's conference!
you have defined low value care, but who makes the decision of what is low value care? Thank you for sharing your work with NAPCRG!
Thank you Dr. Harper for your question and kind words! For this study, we used the Choosing Wisely specialty-specific guidelines to inform our definition of "low-value care". Smarter Care Virginia, a local state-specific initiative with the Virginia Center for Health Innovation, had identified the screening EKG and antibiotics for acute URI as two specific LVC interventions of interest!
Interesting. So glad you asked for patient feedback. Were patients at all part of the design or thematic analysis along the way?
Maret, thank you for your question! The patients were not directly involved in the design or thematic analysis, we felt that it was important for them to be somewhat "blinded" to our aims and question intent. Including them would absolutely be something to consider in the future!
Great poster and video to help describe your research. As a community member, low value care seems like something that should not exist and therefore agree to decrease. However, how do providers build the trust and relationships with patients so that LVC can be avoided and there is trust both ways?
Arturo, I appreciate your question and kind words! We heard a couple of themes and comments that we heard from the patients along the lines of your very question; here are a couple that stuck out to me that increase patient trust: 1) Doctors using clinical language that community members can understand 2) Doctors maintaining a patient relationship over many years. We heard that the longer someone was with a doctor, then more they were trusted 3) Some patients really liked a doctor who was "like them" i.e. similar race, background, SES... 4) Doctors spending adequate time with each patient in the office
Fascinating work! If you take this further or run something similar again, I'd love to know the statistics behind a similar question: "If your physician does not provide you a desired intervention, HOW does that effect your trust?" or something to that effect. Your video indicated that some people answering 'maybe' might have had a change in their trust by being denied LVC, and that change was actually in a positive direction. Trust is such an important topic in healthcare right now - I'm excited to see more work in this area!
Thank you for your comments Kirk! Those that said "maybe" had many reasons why. Usually they would follow up their "maybe" with statements along the lines of "it would depend on how my doctor phrased the refusal" or "As long as my doctor spent time explaining why, I would be ok with the refusal." I hope that's helpful! And yes, you're exactly right - many specifically mentioned INCREASING trust with an adequately-explained doctor refusal. Certainly we should be leveraging that!
Cool twist on looking at LVC. Really nice study. Did you see any differences by gender/race/SES?
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Dennis Baumgardner, MD
11/19/2021Very well done study, poster and oral presentation. Thank you! Dennis