One day I noticed my daughter was watching a reality television show about high school students. The lack of respect that many of them showed towards other students was stunning. What was even more disconcerting was their lack of awareness that the people they were taunting and verbally abusing had the same range of feeling they did; wanted to be accepted and valued as they did; and wanted to belong within their peer groups, just like they did.

The main theme of the program was having a facilitator come into the school and educate the verbally abusive students on the basics of how to have appropriate relationships. It was portrayed that these young people had never seen respect or compassion modeled for them at home. They were not “aware” that other students, young people like themselves, had essentially the same need to belong and the same feelings and desires that they did.

My daughter commented that it was obvious that these insensitive high school students were suffering from low self-esteem to be treating other people that way. This started a conversation about “where do we develop healthy self-esteem from” and why do some people develop it easily and others not at all.

Self-esteem is so intimately connected to whole health and how we treat ourselves; which is also connected to how we treat others. The role of a patient advocate is to instruct a patient on “how to be in the world” and to provide the training, if you will, to have the skills, tools and awareness to develop a strong sense of self and self esteem.

“Roots and wings” was the expression many years ago, which refers to the stability, discipline and security that allows us to go out into the world and have the confidence in ourselves to “spread our wings” and fly.

As parents we have the profound responsibility of modeling to our children what they need to learn to be both healthy and happy. Children learn with their eyes, their ears, and their hearts. It really does not matter what we say to our children, or what we say to others, it is what we do that counts. When we take the easy way out as parents and do not provide our children with a strong example and foundation of learning responsibility, integrity and how to respect others, we fail them and we hurt them.

To educate our children to be healthy and happy we must advocate the number one rule of liking themselves, which leads to liking others: When our behavior is congruent with our values, with what we know intellectually and intuitively is right and good, we like ourselves. When our behavior goes against our values and what we know is the right way to behave, we have low self-esteem. We don’t like ourselves when we behave in a way that directly or indirectly hurts ourselves and others.

I remember talking one time with one of my children who was complaining that they “didn’t like themselves.”

I asked them an appreciative inquiry question: “Do you think that feeling might come from something you know about yourself that the rest of us don’t?” Several days later he shared with me that it “was one of the best questions anyone had ever asked him” and that it helped him to stop doing something that he felt really bad about doing.

This is a question to ask ourselves and to model to our children, who learn more from our non-verbal communication than anything we might “tell” them about how to live a happy life and support their own whole person health.

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

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.

Relationships, Health and Behavior with Dr. Georgianna Donadio

Tag Archives: advocate

Parents Model Behavior and Self-Esteem

How Essential Is Doctor-Patient Communication To Whole Health?