When Assumptions Get in the Way of Care
Why Client-Centered Care Is the Key to Better Health Outcomes. And What Most Providers Get Wrong.
“She’s a liar.” When those words left his mouth, I knew things were about to get interesting in our class. Even though the “she” he was referring to was Charley, a fictional client for a case study we were all assigned to work on during class, it wasn’t the first time I’ve heard those words directly said or implied by a health or wellness professional.
His reasoning, like sadly many health or wellness professionals, was that Charley’s actions didn’t align with her goals. While that part was genuine, the fact that there was a disconnect between what Charley wanted to achieve and what she was ready, willing, and able to accomplish didn’t make her a liar. It made Charley a normal human being who needs support in modifying her behaviors, not another judgmental coach.
That’s why one of the most significant issues with healthcare in the US is the tendency for healthcare providers to make assumptions about clients and patients that aren’t true. Even in my own healthcare experiences, my providers have made assumptions about me that negatively impacted the care they provided.
For instance, when my autoimmune symptoms first began, I went to my primary care doctor to share my concerns. Because I had a “high BMI,” according to her, she recommended that even though I “looked fit,” I could stand to eat more salads. Given that she was the doctor, I listened, even though I knew her advice was biased.
Well, lower BMI and more salads later, I was diagnosed with rheumatoid arthritis and Sjögren’s syndrome. While that diagnosis was affirmation that my health concerns were valid, I was frustrated that my doctor's assumptions contributed to a three-year delay in receiving a proper diagnosis.
As I listened to my classmate call Charley a liar, I was reminded why it’s vital that healthcare providers are client-centered and patient-centered. By this, we center the client and patient in our care. We look at their goals, needs, lifestyles, and limiting factors. In other words, we don’t make assumptions or allow our biases to dictate the care that we provide.
If this is an area you struggle in, here are a few ways to be more client-centered as a provider (or what to look for in a client-centered provider):
1. Client-centered Providers Don’t Make Assumptions.
When we make assumptions, we unfortunately bring our biases to the table. In my classmate's example, he mentioned past experiences of lying to his providers as the reason Charley would lie to him.
However, we are not our clients and should not assume they are doing things just because that’s what we might do in the same situation. Instead of thinking, we ask questions to understand better why a client is engaging in a particular behavior or pursuing a specific goal. The answers will provide far more insight than an assumption ever could.
2. Client-centered Providers Are Active Listeners.
Active listening also means listening to hear, not respond. In my doctor’s example, she was focused exclusively on reviewing my patient's health records, and she forgot she had the patient sitting right in front of her. Even though my records provided her with data she could use, providers must remember that data doesn’t give the whole story, given the limited time physicians spend with patients.
Had she used that data as a starting point to ask more questions, she might have come to a different conclusion that wasn’t the same old weight loss recommendations that, for many years, overlooked my autoimmune condition. Thus, by actively listening, providers can build trust, which is also an effective strategy to combat bias.
3. Client-centered Providers Are Guides, Not Heroes.
I’ve been a massive fan of Donald Miller's book Building a Story Brand because it taught me early on that I’m not the hero but the guide. In other words, providers (guides) are focused on what the clients and patients (heroes) want. For instance, Charley wants to improve her physical fitness by engaging in outdoor activities with her husband. She’s looking for a provider to help her make healthy lifestyle choices, supporting her health goals. For my Star Wars fans, when providers start there, as the guide, they can be the Yoda to their clients' Luke Skywalker (or the Haymitch to their client’s Katniss if you like Hunger Games!) The point is that providers understand their clients' obstacles and guide how to overcome them.
Therefore, providers' tendency to make assumptions might be one of the most significant issues with healthcare in the US. However, client-centeredness is one of the simplest solutions to reduce the likelihood that bias will impact our care.
In a few weeks, I’ll be hosting a free masterclass to explore client-centeredness and how it has impacted the health content I create. If you’re not currently subscribed to the EBWH Community, join now so you’ll be the first to know when we host free classes!
Talk soon,
Tomesha
P.S. If you want another way to support my writing, you can always Buy Me a Coffee!