Fresh Views

Transform Primary Care Encounters: Do Things Differently in 2022

Doing things differently leads to something exceptional. – unknown

Watching the sun set at Wise Villa Winery, Lincoln, California and thinking of new opportunities for 2022

With the start of the new year, one of our goals is to share the basic tenets of a solution-focused approach and how to incorporate these techniques into a brief primary care visit. We’ve had several primary care providers encourage us to share more on this…so here we go launching a series to slowly guide the evolution of practice! Follow our blog so you don’t miss out on practical guidance and tips to transform primary care encounters. (And if you work in a setting other than primary care, you’ll still want to follow because many of the tips can be applied to other practice settings.)

Why do we embrace a solution-focused approach?

Consider this…the traditional medical model of care is “problem-focused” – meaning you need to identify the “cause” to “fix the problem”. However, when faced with a life-long chronic condition (such as diabetes) that requires changes in health behaviors, “fixing a problem” is not so simple. One can quickly feel a sense of failure, feeling at fault where they’ve made “ bad decisions”, or some other negative feeling. 

In our experience, it is common for those living with type 2 diabetes (T2D) to not want to reveal their health condition because of negativity towards T2D in the press, in the community, as well as from the medical field. Blame and shame are rampant. It is hard to be positive and move forward when viewing your whole life through this negative lens. This is where incorporating a solution-focused approach can be a game changer for both the clinician and the person living with diabetes. The whole conversation is “flipped” from a negative to a positive, helping to identify strengths and solutions instead of rehashing all of life’s issues that are not going well.

What is a solution-focused approach to care and education?

A solution-focused approach has its beginnings in counseling psychology, but has made inroads in a number of fields, and we are focusing on application to life with diabetes.  

Here are 7 key tenets of this approach:

  1. Ask questions.  In a solution-focused approach asking eliciting questions is the key to uncovering solutions and guiding the individual. These questions help the individual realize that solutions are possible and help them see their desired future state.
  2. The client is the expert. Key to this approach is first recognizing the individual is a person that lives with their chronic condition on their own and manages their daily life, so they are not a “patient” in this model. They know what they need and understand their condition and how it impacts their greater life. We recognize they are the center of the team and we value their input. Read more about experts here.
  3. If something works, do more of it. The premise here is that if you do “more” of what is going well, then in general you will have less time and opportunity to engage in what is not working well. Helping the individual recognize their strengths and successes builds confidence needed to manage a complex condition. It can be as simple as opening the visit with the question, “What do you feel like has been going well with your diabetes?”
  4. Focus on exceptions.  Exceptions are times when the problem “might” have occurred but didn’t. This could be something small and often overlooked, but when you can highlight these opportunities you can then focus on solutions that are in front of you. You can read blogs we’ve written about exceptions here.
  5. Small changes move you forward.  The goal is to help the client take small steps to move their goals forward and each small step can lead to more success.
  6. Clients already possess the resources they need for change.  Most people are aware of what works for them and have the ability to identify solutions. We can help people to recognize these resources and help them to develop resiliency to manage their condition.
  7. Language matters. We know and evidence shows that the language we use in healthcare is associated with health outcomes. When people are blamed and shamed for their health condition they are less likely to see their healthcare team and less likely to talk with their care team when they are not meeting health goals. The use of person-first, strength-based language in a solution-focused approach is critical to develop a therapeutic relationship with clients.

We hope you will see that this approach can help both clinicians and people with diabetes to collaborate in managing diabetes.

Join us for our series on incorporating a solution-focused approach when managing T2D in the primary care setting. We’ll share how you can incorporate these tenets into a brief visit and how you can build your solution-focused tool-kit over time. Our goal is to start slow and share small, achievable, bite-size practice changes you can implement over time. 

We welcome anyone interested in our approach to Subscribe to our blog and we’ll email you when a new post is published!

If you are a health care professional and interested in learning more about our solution-focused practice and approach, when you subscribe to our blog, we’ll send you in return a FREE resource of 10 Solution-Focused Questions to start a solution-focused discussion with your clients. 

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Deb is employed by Dexcom, but her words and opinions in this blog are her own.

Tami is employed by the University of Kentucky HealthCare Barnstable Brown DIabetes Center, but her words and opinions in this blog are her own.