Evoking Change in Patient Behavior through Motivational Interviewing

By Chad A. Stage
Emtiro Health

We have all been in the scenario of sitting in a small exam room for what seems like an eternity.  Anxiety builds as you await the results of a test or hope that a routine exam is just that, routine, hopeful that each shadow that dims the light at the base of the door is that of your health care provider. The door opens and you are greeted with a bright white coat, and the individual who is wearing that coat has the answers that you are either hoping for or dreading. After being seated on a small stool in front of a computer screen this individual begins an onslaught of personal questions. After, you are given a scripted plan of action on how to address your condition and sent on your way to be that “perfect patient.” 

Many patients are intimidated in health care settings. The mere fact that the provider is holding the knowledge and answers that ultimately affects the patient’s health and wellbeing puts them in a position of power. With that much influence and power, patients will of course do what their provider has directed them to do, right? Wrong. 

Change is difficult even at the simplest level. And because change is hard, patients frequently fall into non-adherence with their health care plan. Many psychological factors must be in just the right place for people to start that exercise program, check their blood sugar, or put down the cigarette.    People have to see something as a legitimate problem before contemplating change. They need to see a change as something that has a high level of importance to their lives. They need to have the confidence that they can make this change and have access to the required resources and support to do so. For patients to effectively process the components of “Is this a real problem," “Is this important to me," “Can I do this?” a dialogue that occurs outside their own heads with someone else is required. This is where the field of Health Care often falls short.

In addition to the health risks of non-adherence, there is a significant financial burden on our health care system, resulting in many estimations of costs in the hundreds of billions of dollars. This should be very alarming to health care providers as we move into a new era of value based care, where these costs may ultimately affect a provider or health systems financial sustainability. 

Emtiro Health knows from experience that these dialogues between patients and health care providers can happen using techniques founded in Motivational Interviewing. Not only does Motivational Interviewing provide the tools to help patients answer the question “Is this a real problem?” but also helps the patient understand why change should be important to them and how confident they are they can succeed. For this reason, our clinical staff are educated and highly skilled in Motivational Interviewing. This model has helped our clinical staff take the facilitator role of our patients’ health care and step out of the health care director role, increasing our rapport with and health outcomes for the patients we serve, while also increasing staff satisfaction.

“I can turn a guarded patient into an open book simply by using my motivational interviewing skills.  Motivational interviewing gets to the root of my patient’s problem and breaks down barriers to success that otherwise would have gone completely unnoticed.”- Jennifer RN, BSN, CCM (Care Manager)

Motivational Interviewing allows our clinical staff to build strong patient relationships because they can gather needed information through guided conversation rather than being tied to a checklist or computer screen.  By harnessing the tools within Motivational Interviewing, our clinical staff are able to engage patients on a more personal level and facilitate health behavior changes much more efficiently than you may find in clinical settings not using these techniques.

Sarah Dohl