Jenn Lonzer and Anthony Stedillie, CEO of CompassMD, discuss the science (part psychology and part data) of bad patients
They’re the ones who start a diet at the urging of their physician, and stop within days.
Bad patients are the ones who, when asked how many drinks they have per week, say 1-2 at most. In reality, they’re having 1-2 by 6:30pm daily.
Bad patients are the ones with home exercise equipment that does little but gather dust, and maybe a few off-season jackets.
They’re the ones who forget to take their medications regularly.
Bad patients are the ones for whom 5-7 servings of fruits and veggies is a good goal for an entire week.
Bad patients use tanning beds and suntan oil, and prefer to be out in the sun at peak times.
They are the ones who only see a doctor when they are ill. And, when they are ill, may not care if they see their primary care doctor or anyone with a pulse and a prescription pad.
Who or what makes a bad patient?
Is ill-health and risk-taking behavior really just the fault of the patient? Does the physician play a role? The insurance company? Society at large?
According to Anthony Stedillie, CEO of CompassMD, a software-as-service solution for insurance companies and large healthcare providers,
bad relationships make bad patients.
Finding the RIGHT good doctor
I had the pleasure of sitting down with Stedillie recently, and over coffee he shared the story of his struggle to find the right doctor, who would relate to him in just the right ways.
While living in Chicago after graduate school, Stedillie had a skin cancer scare. He consulted his insurance company, and knew he needed a referral to a dermatologist. To get this referral, he’d have to find a primary care physician.
Stedillie lived in the heart of downtown Chicago, and remembers feeling as though it shouldn’t be too hard to find a good doctor. The city was crawling with good doctors. The trouble for Stedillie, was finding the right good doctor.
After consulting the alphabetical list of physicians that took his insurance, Stedillie found three doctors. The selection process, for him, was completely random. Stedillie had very little information to go on when he walked into the exam room for the first time.
- Doctor #1 was terrible, according to Stedillie, and completely dismissed his concerns.
- Doctor #2 was the exact opposite, Stedillie told nuviun, and seemed to want Stedillie to make the decision himself about his potentially cancerous tumor.
- Doctor #3 was exactly what Stedillie needed—and finding this physician was a somewhat serendipitous experience for him. A physician who was sensitive to the delicate balance between Stedillie’s health knowledge and his need for medical guidance.
Although Stedillie had no difficulty finding a well-qualified physician, he did have trouble finding a physician to whom he could relate.
Word of mouth referrals and physician ranking services only go so far—and what they leave out could be among the reasons patient engagement seems so illusive.
"Personality is missing from the equation,” says Stedillie. And personality can make the difference between feeling comfortable with your physician or dissatisfied, between following recommendations and completely disregarding them by the time you arrive home from the doctor’s office.
Indeed, as one study of the physician-patient relationship states,
Medicine is an art whose magic and creative ability have long been recognized as residing in the interpersonal aspects of patient-physician relationship.
A physician’s communication style, interests, age, upbringing—and many other life-factors—all influence whether or not a physician is the right doctor for you. Stedillie, an entrepreneur at heart, founded CompassMD because he believes personality should be a key determinant of physician selection.
CompassMD doesn’t rank physicians based on credentials or referrals. And patients don’t have to go to their website—in fact, they can’t—to access the service. Instead, health systems and insurance companies contract with CompassMD, and integrate a 26-question personality assessment into their in-house find a doctor website functionality.
Physicians take the personality assessment at the outset. Once the functionality is rolled out, individuals looking for new doctors take the personality quiz and get a list of physicians ranked according to their compatibility.
And, while there may be some gender differences here, it seems that compatibility makes a difference when it comes to clinical outcomes.
This shows that symmetry in the beliefs that patients and physicians might have about the patients' role in health care can have an influence on important treatment outcomes,
“Matchmaker, matchmaker, make me a match”
If there’s an art to medicine—and I believe there is—then there’s got to be a science of bad patients, and more of an effort to change their health behaviors. I think Stedillie is onto something here: a melding of psychological and data science with art that just might keep physicians and patients harmoniously working toward the same end.
The nuviun blog is intended to contribute to discussion and stimulate debate on important issues in global digital health. The views are solely those of the author.