“You know, doctor, I can’t afford 15 dollars of medicine.”

Sitting in front of me is a young grandmother. She has several problems-including obesity and high blood pressure. She earns approximately $670 a month, most of which is used to pay rent. The rest has to pay for everything else: food, medicine, travel expenses to see the doctor-she hopes to be able to buy birthday gifts for her grandchildren.

I once advised her to start taking extra blood pressure medications.

“Do you want me to see you? Or do you want me to take this new medicine?” She asked me. “I can’t afford the bus and new medicine to your office.”

“What should I do?” she asked anxiously.

I hope she can do all these things: take all her medicine, see the doctor, and Buy birthday presents for her grandchildren. She needs a new care plan.

This story has been with me for a long time. This incident actually occurred before the social determinants of health became an important part of our national health policy discussions, but since the first surgery in ancient times, the social determinants have affected the results.

As doctors, we have received training and will consider the education, cultural background and income level of patients when providing treatment and care. We adapt our methods based on our understanding of the patient’s environment.

However, when we talk about solving social determinants, one thing is usually overlooked-communication-and how we interact with patients in modern times.

Our ability to communicate effectively directly affects patient care opportunities and quality. Extensive research has shown that effective communication is good for patients’ health outcomes.

but More than 70% of health results It is driven by factors other than healthcare. For example, a study found that 5.8 million people In the United States, medical services have been delayed due to lack of transportation. It is estimated that due to cost issues, one-third of adults with chronic diseases do not use prescription drugs. However, they failed to share this information with their doctors, and there was a clear gap in the communication between patients and providers.

If we don’t know how to reach and attract patients outside of the doctor’s office, in a way that suits their life experience and cultural background, then we cannot provide the care they need and deserve.

When we are in the examination room, our patient communication strategy needs to reflect our state of mind: adaptive adjustments based on our understanding of the entire patient.

Many patients cannot wait on the phone for half an hour or more, or cannot wait during traditional working hours. They work in two shifts; they work overnight; they are family caregivers. An email full of medical jargon, jargon, or even English may be meaningless. The traditional one-size-fits-all approach to patient communication does not work (to be honest, it never really works).

Today, we need to communicate with patients like family and friends, taking into account a series of factors such as working hours and preferred language.

It could be an email after get off work, or a series of text messages sent throughout the day, or a scheduled video conference. We may even eventually use a combination of communication channels, timing and language to meet the various needs of patients.and 97% of Americans own a mobile phone, We have the tools to meet the needs of the vast majority of patients.

Only when we tailor our approach to each patient and truly involve them outside the examination room-in a way that suits their lifestyle and experience-can we release the gap between visits and narrowing the gap in care The needs of the patient.

In addition, every patient touch point—whether billing or clinical in nature—can play a role in deepening our understanding of patients. Providers who recognize this and integrate the often different communication touchpoints will flourish in patient-centered care.

As for the grandmother with a tight budget? We were able to reduce the number of medications she needed and find cheaper alternatives so that she could go for inspections and afford her prescription medications. She did buy those birthday gifts.