Episode 13 Rheumy Rounds Pilot Episode: Office Visit Communication Obstacles

Welcome to AiArthritis Voices 360! Today we are introducing Rheumy Rounds™, a concept developed by the International Foundation forAutoimmune & Autoinflammatory Arthritis (AiArthritis) that will unite two very important stakeholder groups - the rheumatologist (as associated rheumatology professionals) and the patient - in roundtable discussions where both parties will be on equal levels discussing important topics that, if solved, can improve outcomes. 

 

By listening to one another's concerns, perceived barriers, and desired improvements, we can begin to develop solutions that will impact patient lives and the rheumatology community as a whole.

 

This is a break out series in conjunction with our AiArthritis Voices 360 talk show (podcast).

This episode, join your patient co-hosts, Tiffany and Kelly, as they are joined by roundtable guests - rheumatologist, Dr. Alfred Kim, and graduate researcher Jerik Leung -as we dive right into the heart of the issue - communication barriers that currently exist between patients and their rheumatologists in the office setting. 

 

Some issues discussed today include:

• How does each stakeholder view the expectations and the goals of the visit and how do they align with one another? 
• When a patient sees a new rheumy they often feel it's "starting over", but if the medical records are intact, the doctor views it a continuation of care - how do these differing mindsets affect behaviors? 
• How do social determinants affect care? (geography, outside social support, income, etc.)
• Rheumies are people too - how does emotional burn out affect visits?

Listen to the episode then take a few minutes to add your comments to the conversation. Based on your input, we will work to build solutions to address this issue and come back with a future episode to build on the discussion. You can join the conversation by submitting comments about this episode using this link.

 

AiArthritis Voices 360 is produced by the International Foundation for Autoimmune and Autoinflammatory Arthritis. Tou can find this episode and more information about Rheumy Rounds, including how to be part of the show and submit future topics, at  www.aiarthritis.org/rheumyrounds.

 

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If you are a patient, a parent of a juvenile patient, or any other stakeholder (doctor, nurse, researcher, industry representative, or other health services person) - are you ready to join the conversation? It's your turn to pull up a seat. Join our new AiArthritis Voices program, where people living with AiArthritis diseases and other stakeholders who we need 'at the table' to solve problems that impact education, advocacy, and research sign up to have a voice in our initiatives. By signing up, you’ll get notified of opportunities to be more involved with this show - including submitting post-episode comments and gaining insider information on future show topics. Patients and all other stakeholders are encouraged to join so we can match you with opportunities to pull up a seat and TOGETHER - as equals - solve the problems of today and tomorrow.

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AiArthritis Voices 360 is produced by the International Foundation for Autoimmune and Autoinflammatory Arthritis. Visit us on the web at www.aiarthritis.org/talkshow. Find us on Twitter, Instagram, TikTok, or Facebook (@ifAiArthritis) or email us (podcast@aiarthritis.org).

 

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Show Notes: Episode 13 Rheumy Rounds Pilot Episode: Office Visit Communication Obstacles (Part 1)

 

00:52 - Tiffany welcome listeners to the pilot episode of Rheumy Rounds

01:15 - Tiffany is joined today by co-host, Kelly

01:36 - Tiffany identifies her diagnoses

01:58 - Kelly explains her diagnosis

02:35 - Tiffany welcomes today’s guests: Dr. Alfred Kim and Jerik Leung

03:01 - Kelly introduces Dr. Kim and Mr. Leung and explains their work focus in the AiArthritis Community

04:54 - Tiffany explains the goals of the Rheumy Rounds Series

07:04 - Today’s Topic: Improving Doctor / Patient Communication

08:12 - Jerik’s research showed that patient goals did not always align with the physician’s goals, especially relating to medications and side effects

09:20 - Patients who are not connecting with their doctor and aren’t understood by their family will often seek out online communities so that they feel understood by someone 

13:05 - Dr. Kim says the primary goal of rheumatologists is to determine what is actually going on with the patient. Are additional testing or imaging studies necessary? Are the notes from the previous doctor or patient provided information enough?

13:54 - Practicing Rheumatology is somewhat similar to practicing psychiatry in that there are usually not clear cut answers divined from test results.  The physician has to review as much information as possible to arrive at a correct diagnosis.

14:50 - Rheumatologists must also prepare to have a difficult conversation with patients if the diagnosis doesn’t align with what they have been told previously or what they believe or don’t believe they have

15:13 - Sometimes patients arrive at a new doctor with incorrect information in their chart because a previous doctor had to use a certain diagnosis - even if it wasn’t the correct one - so the patient could get access to a needed medication

17:13 - Rheumatologists primarily base treatment plans on symptoms, rather than diagnosis. This is different than 99% of medicine practice and is confusing for patients.

20:08 - 80% of health outcomes are determined by social determinants, and only 20% is based on medical care

20:14 - Social determinants are the variables of how your living and working situation influences your health (income, education, social support, addiction status, employment status, etc.)

20:40 - Physicians have no meaningful training in influencing social determinants in their patients

23:30 - Patients really benefit from having collaboration between their doctors and having someone coordinate the services they need - both medical and social determinants - all in one place

29:45 - Physicians must translate colloquial information from the patient to technical information so that it will align with their training and then translate it back to colloquial format so the patient will understand it and be able to explain it to their social support network

30:18 - Physicians receive no formal training in communicating effectively with patients

32:33 - Patients should document concerns as they go so that they can communicate them effectively with their physician 

32:50 - Shortened appointment times, electronic medical records requirements, and overwhelming workloads all contribute to emotional burnout among physicians who want to provide emotional support for patients