Clients speak up

Has a health professional ever asked you, “In your opinion, what could you do to improve your situation?” Surprising isn’t it?

The world of health care is constantly changing. Gone are the days when our doctor was responsible for our health. Today, more physicians work in teams with other health professionals, but especially with the clients themselves. Research shows that to improve public health, health professionals not only need to help change their clients’ habits, they also have to involve them in the process. Why?

Researchers have discovered that people who consult a health professional to obtain THE SOLUTION seldom find it produces satisfactory results. And health professionals have long found it frustrating to see that their clients may not follow their recommendations.

This is why increasing numbers of health professionals are abandoning the traditional approach of providing advice in favour of the “motivational interviewing” technique currently being used in the health care field, including at Centre de santé. William Miller and Steve Rollnick developed this technique in 1991. The health professionals’ task involves helping their clients to manage their own health.

In practical terms, health professionals start a motivational interview by establishing a diagnosis based on the examination results. They then ask their clients what they know about their disease or the behaviour that they want to change. Since many clients obtain information from the Internet, it is a good opportunity for the professional to determine whether or not their clients are well informed. In cases where clients have obtained incorrect information (for example, from the Internet or a well-intentioned but ill-informed friend), the professionals ask their clients whether they would like to hear their advice. Some discussion takes place before the clients and the professionals arrive at a consensus. This is the point at which the clients take the first step towards becoming accountable.

Solutions are discussed next. The health professionals provide their clients with several options. They lay out all the possibilities. The clients have now become members of the health care team. Why is it important that the clients choose? We now know that when clients are forced to accept a solution, they are less likely to make the suggested changes.

Take someone who has high blood pressure, for example. There may be several ways to reduce the hypertension: the client can reduce his stress, quit smoking, eat less salt, take medication, etc. The professional’s initial reaction could be to think that the first thing this person has to do is to stop smoking. But instead, the professional asks the client, “What could you do to improve your situation?”

If the client answers, “Listen, I’m going to be very busy at work during the next month, and I don’t think I could quit smoking,” the professional can then ask him to choose a more “realistic” change given his current personal situation, and suggest that he consider quitting when his situation improves.

Clients who have benefited from this approach are more successful at making lasting changes. Some clients are surprised by the questions, but quickly feel that they are part of the team, and become committed to dealing with the situation. They often respond by saying, “Hmmm, I never thought of that!”

And by thinking about it, clients become involved in their wellness plan. From the health professionals’ standpoint, by asking these questions, they can better assess their clients’ ability to initiate the healing process. This is reflective of the trend that is seeing clients becoming more responsible for their own health. What do you think?