Dr. Natasha Burgert
Dr. Rob Lamberts

Khan Academy Inspires Flip of Doctor-Patient Relationship Model

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Editor’s note: This guest post was written by Dave Chase, the CEO of Avado.com, a patient portal & relationship management company that was a TechCrunch Disrupt finalist. Previously he was a management consultant for Accenture’s healthcare practice and founder of Microsoft’s Health platform business. You can follow him on Twitter @chasedave.

Education and healthcare are typically held up as the industries least affected by the technology revolution, however this has begun to change. From Bill Gates to millions of students and parents, the Khan Academy has impressed many of us and inspired teachers to flip the classroom lecture/homework model on its head as described in the video below. Doctors are now recognizing similar value in videos for their patients.

Read more about flipping the classroom in The Economist

As you can see in the video, technology has brought a human element back into the classroom making it more interactive and tuned to specific kids’ needs. Why limit this to students? Why not use this model to help improve health outcomes? In fact, we may not have a choice with the ever-increasing shortage of primary care physicians. One can look to what happened after Romneycare was implemented as a preview of what is to come. The shortage of primary care providers only increased. Simply trying to put family physicians on a faster hamster wheel isn’t the solution.

It’s been reported that individuals forget as much as 80-90% of what a doctor tells them. One of the nice things about Khan Academy is learners with different skill levels can watch the videos in different ways. Some may get it just watching it once while others may want to replay the video over a few times before a concept sinks in. In many ways doctors are teachers wearing white coats. In fact, they have taught many of the same lessons hundreds or thousands of times. Some forward-looking doctors have caught on to this.

Click here for the accompanying blog post on Understanding Growth Charts.

Perhaps because Dr. Wendy Sue Swanson was a teacher before she was a pediatrician, she was naturally drawn to using her videos and blogs to benefit her patients’ families. [Disclosure: Dr. Swanson is a Medical Advisor to my company, Avado.] Dr. Swanson shared the reaction she gets from patients. “I’ll launch into something in clinic and a family will say, ‘Dr Swanson, you don’t have to explain that, I read your blog post/saw your video, etc!’ We start at a different place. A place that feels easier to connect, more informed, and one with more respect for our mutual vantage points.”

Dr. Rob Lamberts wrote a piece entitled Riding Dinosaurs. He has recognized the shortcomings of an office visit that is heavily driven by the billing needs versus a long-term focus on a patient’s overall health. In his own way, he’s suggesting a model for higher value physical exams.

If there is a need for seeing the doctor in person, 95% of the encounter is already done and documented, leaving only the physical exam to be done in person – something that can be accomplished in a few minutes for the vast majority of visits.

Dr. Natasha Burgert has written about how social media has changed her medical practice. Here is how she describe the benefit to her practice and patients.

Investing time in relevant and complete posts actually saves me time in the long run. Questions I am repeatedly asked,  like “How do I start solid foods?“, can be answered quickly and completely by directing them to my site. This saves face-to-face clinic time for more specific concerns for their child. I can actively communicate, acknowledge, and positively influence the choices that my families make for their children between the checkups. My anticipatory guidance can be repeated, reinforced, and repeated again.

Dr. Burgert explains The New Infant Acetaminophen (Tylenol) in this video:

Of course, the benefit of doctor videos aren’t limited to primary care. Specialists such as Orthopedic Surgeon, Howards Luks, also have been realizing the benefit of videos. [Disclosure: Dr. Luks is a Medical Advisor to my company, Avado.] As Dr. Luks states, “Every patient who sees my videos prior to their visit says. ‘OMG it’s you, you’re just like you are in the videos.’ Very powerful. It humanizes your practice.” The video below is an example of Dr. Luks’ video explaining Achilles tendon ruptures.

Bit by bit, there is major change underway. Many doctors, particularly in primary care, are unhappy about the way they have been practicing and are unleashing their own creativity. Here is how one describes how these current delivery model changes are:

So much of our present care delivery is rote and could be practiced online or provided via video/blog/text. And that the ‘real medicine,’ the service and the relationship or helping people in moments of anxiety and indecision are rare and undervalued. That oddly enough, there is simply no time in the day to do what matters most. Or if we get the opportunity to forge a real partnership, it comes at the cost of making somebody wait, and running late. So yes, we’re headed in the right direction by making these changes.

Naturally, startups are building from this foundation and innovating beyond simply using YouTube. I’ve had the chance to see some products not yet generally released that take this much further. [If you've seen any new video tools in use in healthcare, add a link to them in the comments below.] As Salman Khan has shown, it doesn’t necessarily take radical new technology to reinvent or re-imagine change. Rather, it is imperative to make creative use of existing technologies in order to thrive in the future.