Who Will Be Involved

Formal studies and anecdotal reports have consistently indicated that involvement of all of the office staff in patient education increases the total impact and saves the physician time. The physician always needs to be involved in defining the educational goals, delivering brief messages about the importance of goals, prescribing an educational process, and following up regularly to assess progress. Depending on the physician's interest and the nature of the problem, the education can be given by the physician or delegated to office nurses and other staff. Reception staff can suggest printed materials or other available modalities to patients while they wait or can be involved in giving patients printed materials prescribed by the physician. Group classes can be offered in the evening, organized around common topics within the practice. If these are run in conjunction with existing evening clinic hours, group classes can be a time-efficient method of delivering education to select patients. In larger practices, interested staff can form a patient education committee who uses a quality improvement process to foster patient education.

Available community resources should not be overlooked, including professionals such as dieticians and diabetes educators who may be hired on a full-time or part-time basis by a larger practice or who can split their time as a "circuit rider," spending a few hours each week at several practices. Many communities have existing programs for smoking cessation, weight loss, stress reduction, and exercise. Physicians can spend some of their time or their staff's time to become familiar with the programs, their costs, and schedules. In some cases, physicians' involvement as a medical consultant can lead to an improved program.

Remember that almost all patients have a family context. For example, whether a spouse smokes is an important factor in a smoking patient's efforts to quit. Similarly, if a patient needs to learn about dietary change to lower cholesterol and the spouse does all the food preparation for the household, the instruction will not be likely to affect the target behavior without involvement of that spouse.

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