Community Toolkit: Education For Barriers in the Practice Setting

Although a practice group may have good intentions and knowledge of the prevention and management needs of its patients, actually achieving these goals is never easy. Before approaching a potential healthcare practice partner it is important to understand some of the real-life obstacles they encounter.

Doctor on computer Below are a few examples of some of these barriers:
  1. Health care practices have limited resources to assess or follow-up with preventive health or disease management behaviors. While the time commitment per patient may seem small, even a few added minutes with each patient can impact the efficient flow of the clinic. Lower efficiency means that fewer patients can be seen, and this can be costly.
  2. Health insurers rarely pay for preventive activities such as patient assessment, counseling, maintenance or resource referral.
  3. It is difficult for some practices to see any direct benefit from trying to provide these services to individual patients. Clinics often lack feedback and follow-up systems that allow individual providers to see the result of their health promotion efforts.

With so many obstacles to face, any lasting strategy to increase practice-based health promotion and disease management services will need to address these issues.

Below are some tips for overcoming some possible difficulties:
  1. Remain flexible, remembering that most clinics can not provide all services to all of their patients.
  2. Limit any new direct costs to the healthcare practice.
  3. Minimize involvement of existing clinic personnel such as clerks, medical assistants, nurses, and doctors.
  4. Have a good strategy that will mesh well with current clinic procedures and whenever possible, utilize other clinic programs that deal with health and disease management behaviors. For example:

    • Some clinics may already use a waiting room questionnaire to ask about tobacco use, but not about physical activity or diet.
    • Some may use nurses, dieticians, or health educators to deal with unhealthy habits in patients with diabetes but not other conditions.
    • Others may have complex disease management programs that combine education and case management to improve self-care for patients with diabetes, asthma, or heart failure.

As a starting point, it is often very helpful to determine if new efforts can be linked to or delivered in a way that is similar to any ongoing efforts. This means that local efforts must be tailored to specific healthcare practice partners. To achieve this, you will need to gather more information about your potential partner.


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