How to be aware of patients’ non-medical needs

“It kind of strips you of any pride that you have. It was very humbling.”

As a care manager, Mary helps patients follow their care plans by coordinating medical visits and community resource referrals, but this was the first time Mary shadowed one of her patients out in the community. At the food bank, Mary watched her patient, who was living with diabetes, receive one box of macaroni along with other canned and shelf-stable food items. A key part of her patient’s care plan included a monitored diet of carbohydrates, but it became clear to Mary that her patient would have difficulty managing her diabetes while depending on the food bank for food security. Seeing firsthand helped Mary understand that the non-medical needs surrounding her patient’s chronic condition would ultimately affect her patient’s ability to comply with care plan recommendations, and this observation informed Mary’s practice:

I try to give as much information as I can to get [providers] to understand what [patients] are going through. [Patients] aren’t intentionally trying to be non-compliant. It’s not like they have this endless money pit to go buy spaghetti squash. They just don’t have that option. They have macaroni. We’re working with macaroni here.

Following Mary’s example, shadowing patients outside of the medical clinic is one strategy providers can use to become more familiar with their patients’ non-medical needs. Directly observing the social and economic barriers patients face may increase providers’ empathy towards challenges that seem mundane but are consequential for health outcomes. Patient shadowing may also facilitate improved communication between providers and their patients — if providers can leverage the insight to better inquire about their patient’s situation. Moreover, providers with a large panel of complex patients can use the shadowing strategy as an opportunity to assess the value, appropriateness, and capacity of their local network of community resources.