The Importance of Patient-related Cultural Humility

In the era of value-based care, understanding where the patient is coming from and engaging them is as important as ever.

The need for cultural competency in healthcare came from the rise of hospitalist medicine, explains O'Neil Pyke, MD, CMO of Medicus Healthcare Solutions, a locum tenens staffing company based in Windham, N.H.

Pyke knows a few things about hospitalist medicine. He is a practicing hospitalist physician for 17 years at a large teaching institution and runs his own hospitalist consulting firm, AMP Hospitalist Consulting on the side.  He explains how he came to recognize the importance of cultural competency through his work in this area.

"About 20-25 years ago in medicine, healthcare had a major change in that this new specialty called hospital medicine basically came to be….instead of having patients by seen [in the hospital] by their primary-care doctors who they know and trust…these primary-care physicians started en masse retreating back to the office and only seeing them in the office setting and relinquishing the care of their patients once they got hospitalized. The issue with that is a patient seeing a new doctor at their sickest can be very uncomfortable. The doctor needs to bring that communication cap very quickly and gain that patient's trust. That's what brought me into cultural competency in the first place," he says.

The ideals of cultural competency are about developing tools which allow physicians to be better communicators with their patients. It's about understanding another person's culture and background to figure out how to best connect with and care for that patient. Pyke will be giving a talk on cultural competency - or as he has started to call it, "cultural humility" - at the annual MGMA conference, held this year in Anaheim.

While this concept is important for hospitalist-based physicians, Pyke has recognized that it's important for all physicians and all healthcare providers to use these tools. This is especially true in the era of value-based care, where providers will be paid based on the patient's actual experience rather than the volume of care they provide.

"Over the last several years, the penalty for patients having a sub-optimal experience [while they are in a provider setting] is a much more real number than in previous years. That has been a driving force for not only people like myself [who think this is the right thing to do], but [more] healthcare providers are recognizing…they are going to be penalized [in]…value-based purchasing [models]," says Pyke. He specifically points to CMS' value-based purchasing model, which upped the penalty for sub-optimal patient experiences (based on the Hospital Consumer Assessment of Healthcare Providers and Systems' survey) from 1 to 2 percent.

"With the narrow margins [providers] are working with, 2 percent on their CMS repayment can be a significant money. All healthcare leaders are acutely aware they have to pay attention [to the patient experience] from a financial standpoint, in addition to being the right thing to do for patients." Other value-based models, he says, will likely factor in the patient experience as well, if they haven't done so already.

For the session, Pyke plans on explaining cultural competency/humility and it's importance. He'll also share some simple tools that will help practitioners become better at engaging patients, rather than simply dictating care plans to them. His session, "Cultural Competency for Patient Engagement" will be taking place on Monday, October 9th at 2:45 p.m. at MGMA17.