Listen up: Podcast helps doctors have tough patient conversations

Sara Berg
Senior Staff Writer
AMA Wire
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For many physicians, having difficult conversations with patients is a part of daily practice. A new podcast series produced by the AMA features physicians’ eye-opening encounters with patients and real-world solutions and insights. A recent episode addresses the challenges physicians face in helping their patients with chronic conditions.

The new podcast, “AMA Doc Talk,” recently released its third episode, “Coping with Chronic Disease.” This episode examines how patients’ relationships with their care teams can affect the way they manage their chronic disease. The first season of the podcast includes a total of six episodes released this winter.

Hosted by Rajesh S. Mangrulkar, MD, associate dean for medical student education at the University of Michigan Medical School, season one of “AMA Doc Talk” started in January.

Relationship-building with patients is critical

In the third episode of the season, Dr. Mangrulkar is joined by Rushika Fernandopulle, MD, MPP, a practicing physician and co-founder and CEO of Iora Health. Together they discuss how physicians and their teams can improve the management of patients’ chronic disease.

“There is no quick fix for chronic disease, but finding the right words to help a patient through this challenging and sometimes seemingly endless journey can help make the road smoother and even the outcomes better,” Dr. Mangrulkar said on the podcast.

And since “medicine in general has evolved around an acute care model,” Dr. Fernandopulle believes that chronic disease management is much harder. However, that difficulty does not typically encompass diagnosis, he said. The hard part is actually how a physician manages chronic disease over months, years or a lifetime.

“Both our way of thinking and our systems are not evolved, unfortunately, to take care of that,” he said. “For better or for worse, 60 or 70 percent of what the burden of illness is now is increasingly chronic disease.”

“Meaning that, our patients, when we look at their outcome, 60–70 percent of them are driven by the impact of chronic disease, yet our systems are set up to better handle acute disease,” said Dr. Mangrulkar.

Caring for patients with chronic disease does not rest on the primary care physicians’ shoulders. Whether a physician is a cardiologist, gastroenterologist, endocrinologist or a surgeon, everyone will have to provide ongoing care for chronic disease, said Dr. Fernandopulle. He recommends taking on a relationship model because the problem can’t be fixed during the first office visit.

“I think building a relationship with a patient is what’s really important because they need to trust you, right?” he said. “The second principle is that this myth of I, the doctor, will manage your disease.”

The management of chronic disease does not lie solely with the physician. Dr. Fernandopulle and Dr. Mangrulkar jointly agreed that the patient and the family need to be able to manage their health. In turn, the health system and physicians can help provide the necessary tools to guide them in doing that.  

Upcoming episodes for season one of the podcast will focus on patients self-diagnosing, helping patients gain clarity on a rare disorder, and what and how to say something to help position patients for success.

Previous episodes include “Telling a Patient They’re Going to Die,” which discusses ways to provide comfort and guidance to patients and their families, and “My Patient Won’t Listen to Me,” which helps physicians working with patients who skip medication, miss appointments or don’t heed medical advice.

Check out “AMA Doc Talk” on iTunesStitcher or wherever you listen to podcasts. Listen, subscribe and share the new series with your social networks using the hashtag #AMADocTalk.

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