NOTE: The following is an excerpt from TeleVox’s Healthy World report, “Discussing Diabetes: The Essential Conversation That Could Change the Health of the Nation”, which examines the idea of technology-enabled between-visit engagement to help patients with the prevention and management of diabetes. Download it HERE!
For communication to really deliver results, it helps to understand the gaps between the perceptions of doctors and patients. Discussing Diabetes shows that when it comes to diabetes — and health issues related to weight in general — there are three broad areas where medical professionals and the general public are not yet on the same page. Bridging these gaps is the necessary starting place for preventing and treating diabetes in the United States.
Disconnect Three: Staying the Course
Having seen plenty of people attempting to lose weight during their time in practice, physicians have more of a ‘slow and steady’ approach to weight loss than their patients. Discussing Diabetes shows that doctors are much more likely to say that failure comes from not setting realistic goals in the first place, trying a fad diet that didn’t work, or the absence of a good support system, such as encouragement from friends, family — and even from doctors.
Nearly three quarters (73 percent) of diabetic patients in the Discussing Diabetes survey said that making small behavioral changes, such as replacing sugar with a diet sweetener or eating slower, would be the most successful way of losing weight, rather than making several significant changes at once. However, 84 percent of doctors think that for long-term success a series of small adjustments works better than a complete lifestyle overhaul. The proportion of patients who believe they would best be served by a major step change far outnumbers the percentage of doctors who feel the same way.
When it comes to giving and receiving advice, more than two thirds (67 percent) of people said they would find broad advice and guidance more helpful than being told exactly what steps to take. In an interesting contrast, more than half of doctors said that telling the patient exactly what steps to take to manage their weight would deliver better results than giving the patient advice and then letting him or her figure out on their own what works best for them. Despite this, only 43 percent of doctors admit to telling the patient exactly what steps to take.
Survey respondents are also very clear that they prefer a ‘carrot’ to a ‘stick’ when it comes to staying motivated. Nearly three quarters (73 percent) said they would be encouraged by moving towards pleasure and achieving positive outcomes. Feeling healthier, being happier with their appearance, having more energy and living longer were all popular motivational ideas.
However, this number drops to 63 percent among those already diagnosed with diabetes, suggesting that the more real those negative outcomes become, the more likely they are to drive a change in behavior and lifestyle.
In one of the more startling differences of perception that come to light in Discussing Diabetes, more than one third (35 percent) of patients diagnosed with diabetes who have been told to lose weight by their doctor said they had been offered a combination of positive and negative motivations to lose weight. Two in ten (19 percent) said their doctor had focused on the positives, while three in ten (28 percent) said their doctor had focused only on the negatives.
But this is not what doctors are saying. When discussing weight loss with a patient, three quarters (76 percent) said they use a combination of carrot and stick, positive and negative. Eighteen percent say they focus solely on the positives. But only six percent say they talk about the negative outcomes of failing to manage weight effectively. Patients and doctors are not seeing their conversations in the same way.
Reinforcing the belief among many doctors that patients could and should be more proactive and take greater responsibility for managing their health, one in four people diagnosed with diabetes who took part in Discussing Diabetes think there is a lack of available resources to help successful weight management. But a slightly lower percentage of doctors believe that a lack of resources is a problem: only one in five (18 percent). By the same token, more than half (51 percent) of diabetics surveyed believe that children are not getting adequate education about healthy eating choices — but only a third of doctors (37 percent) agree. Either the information is out there and patients are unaware of it or think it inadequate, or the medical profession simply has greater faith in the usefulness and accessibility of materials provided.