Gastroenterologist Dr Chau Che has developed a two-minute strategy aimed at persuading patients of the importance of being vaccinated against COVID-19. In MedpageToday, she writes that key to the strategy is stressing that as their physician, you always have patients’ best interest in mind. Eight in 10 patients respond positively.
Dr Chau Che, of Temple Physicians in the United States, wrote in an opinion article in the open access MedpageTodayon 22 August 2021:
I am a gastroenterologist. I do colonoscopies to remove polyps to prevent colon cancer. I never thought I would be speaking to patients about vaccinations. That has changed with COVID-19. Everything has changed with COVID-19.
There is so much misinformation and everyone has seen this term: vaccine hesitancy. The vaccine-hesitant are people who are not ready to get the vaccine for a host of reasons. It may be the lack of full US Food and Drug Administration(FDA) approval, a side effect they heard about from a friend of a friend, belief that the vaccine can cause COVID-19; the reasons are endless.
While a limited number of hesitant people may be scared into getting the vaccine because the Delta variant wave is filling up hospitals with unvaccinated patients, at this point, the government messaging, incentives, and outreach programmes are unlikely to change the minds of most vaccine-hesitant people.
This is where us healthcare providers who are seeing patients in-person or through virtual visits come in. We need a grassroots effort starting with local healthcare providers who patients go to see when they're sick.
Dr Chau Che continues in the MedpageToday article: It does not matter what type of physician you are. If you're a dermatologist, surgeon, gastroenterologist, rheumatologist, gynecologist, allergist, or any other patient-facing provider, you will have office or telemedicine visits with these vaccine-hesitant patients.
They may have been your patient for 15 years now or 15 minutes – seize your time with them to make a difference and empower them to get the vaccine.
I've seen my messaging work and have successfully convinced patients to get vaccinated against COVID-19. Recently, I've even felt a greater sense of accomplishment in convincing patients to get vaccinated than from removing a polyp to prevent colon cancer or treating hepatitis C.
For my colleagues who say there is simply not enough time during an office visit to address this, I recommend a two-minute strategy. It takes up a brief part of each visit and the difference starts with that one patient. I save the discussion for the end of the visit as I want patients to realise the importance of the issue. No matter how long the appointment has already been, I will always bring it up during the visit.
There are courses on the stages of change – I even did a primary care residency and had teachings devoted to the stages of change to empower patients – but I do not have enough time during a patient visit to employ all these methods. There are time constraints on a busy practice. I do not ask open-ended questions as I have been taught to do, but instead, I direct the conversation.
I have tried various methods to get people to take the vaccine, including anger, frustration, and scaring patients, writes Dr Chau Che in Medpage Today. It has not worked. I have pivoted my methods and have been much more successful with my new strategy.
Here's are the steps to my two-minute approach:
- Acknowledge the misinformation and the patient's apprehension.
- Remind the patient of your physician-patient relationship over the years (if applicable) and that above all else, you have the patient's best interest in mind. I remind my patients that they come to me for their health, which includes vaccines since I am a physician. They never took health advice from the news, friends, or the internet before without consultation, why are they starting to now?
- I speak about receiving the vaccine myself and how I have no doubt that this was the best decision.
- Lastly, I speak about my children. Many of my patients know me from having no children to now having three, asking to see pictures of them over the years. I talk about how I cannot wait to have my children vaccinated as well.
- I finish off by coming full circle and acknowledging my patient's apprehension once more, but I also remind my patient again to have faith and confidence that I, as their physician, will always have their best interest in mind.
After my two-minute speech, I ask my patients if I can help schedule their vaccination. Since employing this method, about eight in 10 patients will move from the contemplative stage to the action stage of getting a vaccine. For those who are still contemplative, I let them know that I am here to answer any other questions, and when they are ready, I can guide them to a pharmacy or help schedule their vaccine.
Dr Chau Che concludes in Medpage Today: I am not working in the hospital and seeing patients who are arriving sick and unvaccinated with COVID-19 from the Delta strain. But my fellow colleagues are, and encouraging my patients to get vaccinated feels like the least I can do to try to prevent one more case of COVID-19.
I ask my fellow healthcare providers, physicians, nurse practitioners, physician assistants, midwives and dentists to take those two minutes with these vaccine-hesitant patients to try and push them from the contemplative stage to the action stage.
It doesn't matter your specialty or years of experience, we must tap into our unique patient relationships. It has come down to a grassroots effort, and with each and every one of us trying, we can make that difference.
Dr Chau Che is a gastroenterologist for Temple Physicians.
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