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Provider Communication Drives Patient Trust in Aging Populations

The key to serving an aging population with changing healthcare needs is creating patient trust, according to Louis Levitt, an orthopedist.

patient trust

Source: Thinkstock

By Sara Heath

- As the Baby Boomer generation begins to consume healthcare at an increasingly higher volume, medical providers will need to determine strategies for engaging these patients and gaining patient trust.

This will be especially important in orthopaedics, where experts have already begun to see an influx of Boomers accessing care.

Baby Boomers have always been generally healthy, according to Louis Levitt, MD, an orthopedist and vice president of the DC-based Centers for Advanced Orthopaedics (CAO). From his experience, Baby Boomers have long made exercise a priority. While Boomers aren’t quite as fitness-obsessed as their younger Gen X or Millennial counterparts, they introduced a new level of health into the industry.

“But obviously the aging process has begun to put them in just a different category,” Levitt said in an interview with PatientEngagementHIT.com. “Everybody's falling apart slowly, surely, and inevitably. That's a dilemma for Boomers who never saw themselves as anything but indestructible.”

Increased healthcare utilization from the large swath of Baby Boomers has introduced tremendous change in the healthcare industry. Overall healthcare spending is going up. Doctors who are also Baby Boomers are beginning to retire. Patient health needs are different, more complex, and needing more keen attention.

READ MORE: As Health IT Evolves, Patient-Provider Trust Remains Essential

This has introduced a paradigm shift, Levitt asserted, and providers need to keep pace to gain patient trust.

That doesn’t necessarily mean providers will experience a changing tide in how these patients approach care access. Just as they did when they were younger or needed care for their children, Baby Boomers will continue to rely on the opinions of their friends, families, and trusted family physicians for care.

“Boomers have long standing relationships with their primary care physicians,” Levitt explained. “Wherever that primary care physician refers them, they will go. Boomers are also very heavily dependent on reputation of the doctors.”

Practice leaders would benefit from bearing that in mind, Levitt said, even as they face calls for new engagement approaches that fit the needs of younger healthcare consumers.

The primary way older patients – the population that utilizes healthcare and orthopaedics the most – access care is still a referral from a primary care doctor. These patients will sit in the waiting room for up to even an hour, Levitt said, especially when the physician comes with a PCP’s seal of approval.

READ MORE: Does Patient Trust in Clinicians Improve Patient Satisfaction?

Baby Boomers’ care access habits introduce the first element of gaining patient trust. Clinicians must continue to foster their positive reputations among their colleagues and clientele who are most certainly sharing recommendations.

“These patients are heavily influenced by things like the top doctor in the community as printed by the local commercial magazine, doctors they may see on television who set themselves as experts in particular areas, whether it be spine or total joints,” Levitt explained.

And once the patient gets into the office, the clinician must reassure them of her qualifications to treat their ailment.

While younger patients may value promises of convenient and high-quality care, Baby Boomers want to see an experienced doctor – not nurse practitioner or physician’s assistant – who has completed a certain treatment numerous times.

“The older population always wants somebody that's done a thousand operations or has the best reputation,” Levitt noted. “All you can do is reassure them that after a 35-year career, you've done hundreds of everything, and you don't have to tout it, you don't have to promote yourself as having super skill sets.”

READ MORE: Patient Satisfaction and HCAHPS: What It Means for Providers

Younger clinicians can engender the same type of patient trust by touting other areas of their expertise. Although they may not have been in practice for 35 years, they can lean on their interpersonal skills to emphasize their qualifications and put patients at ease.

It’s those interpersonal skills that Levitt said are most important while building patient trust. While the Baby Boomer population begins to experience new health ailments – in Levitt’s practice these include arthritis and other joint pains and issues – they must adjust to a new set of treatment options.

Typically, Baby Boomers want fast treatment and to be back to their active lifestyles quickly. Baby Boomers’ parents tended to be more sedentary, and Levitt has interacted with many patients who want to avoid the same fate.

“They want desperately to be considered young, not old,” Levitt explained. “They don't ever want to hear that they're too old to get a particular type of procedure done. They think they're young and they should be entitled to everything that a younger generation is entitled to, but there are just some operations you would not do to an older population that you would do to a younger population.”

Levitt might prescribe an arthroscopic procedure to a young man in his 30s or 40s who injured his meniscus, but not for a 70-year-old. If the 70-year-old’s knee is showing signs of arthritis, the arthroscopy would do more harm than good and advance the arthritis.

But that’s not the answer most 70-year-olds want, Levitt said, noting another challenge in building patient trust.

Again, Levitt leans on his interpersonal skills to set a specific tone with his patients and assert that his goal as a provider to is preserve a patient’s lifestyle.

“If you let the patient know it is your responsibility to them to keep them active as possible for as long as possible, then they'll buy into your treatment recommendations,” he said.

Levitt would never recommend a lifelong runner to stop running at the first sign of arthritis, or a 75-year-old skier to quit out of concern for falls and broken bones. Those activities are what give patients their zest, Levitt said, and what will keep them healthier for longer.

“I let the patients know that my goal is to keep them as functional as possible and let them retain whatever lifestyle they have,” he explained. “If I think it's really detrimental, then I'll make that recommendation.”

Once an activity becomes untenable for a patient between pain and other health risks, Levitt recommends a tapering down.

Levitt also gains his patients’ trust and respect by acknowledging where therapy isn’t necessary, or he isn’t the most fit to conduct it. Levitt is comfortable referring his patients when another clinician is more skilled at a certain procedure, and he is able to determine whether a test is necessary for a patient who would face a high out-of-pocket bill.

At the end of the day, Levitt credits his 35 years of healthcare experience with these capabilities, although that doesn’t mean a younger doctor cannot obtain the same skills. Medicine is about building rapport and working well with people. Being sensitive to cultural needs and age will build provider empathy, making that clinician all the more effective.

“Some of this is stuff they just don't teach you in medical school, it's just learning how to develop a patient rapport based on the patient who’s sitting in front of you,” Levitt concluded. “Learning how to be a doctor is principally learning how to relate to the patients, at the patients' needs at that time. What you can't do is have a set of prescriptions that you make everybody adhere to. There has to be flexibility in your managing a patient.”

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