"Portals are good and bad," he says. "Some patients love it. The technology allows patients to go more in depth with education and articles I can put out on the portal for them, and that's where it's positive. But the above-60 crowd, who has much of the chronic disease, does not use it as much as younger patients. They want one-on-one time. My goal is to have an app that fits in with patients' lives."
The tug-of-war between giving a patient more time or more technology is a struggle that most healthcare providers continue to have; however, as some organizations have found, it is a combination of both that has the best chance of getting a patient to be an active healthcare partner.
As hospitals and health systems continue to grapple with patients who have significant health issues but little motivation, Bothe says it is important to remember that health literacy is a significant challenge.
"How readily patients can have a conversation with their provider is a two-way street," he says. "If a provider recognizes a patient has limited fluency with medical terms, the provider needs to change the vocabulary and the pacing of explanations."
It is also the tone a provider strikes with a patient. Empathy is what Jones valued with Berry so much that she followed him from one clinic to another. That five-year relationship led to an extreme turnaround in her health. Remarkably, Berry did not ever ask Jones about her weight. Should he have? Jones says yes, probably, but she was relieved he didn't because it was embarrassing. Berry says more doctors need to recognize the delicate balance of knowing when to talk to a patient and when to listen.
"It gets back to that need for us doctors to be sensitive, to not be seen as accusers or judges to people who may already feel ashamed," says Berry.
And though Jones is no longer under Berry's care because she doesn't have diabetes and because he's also moved on to help another Dallas clinic become a FQHC, they still keep in touch.
"I miss him terribly as my doctor," says Jones. "I miss him praying with me. I had been able to talk to Dr. Berry about not just physical stuff, but hurts in my heart. He always took his time with me. I still feel that the doctors at Mission East treat all of me—the physical, emotional, and spiritual."
This article appears in the July/August 2015 issue of HealthLeaders magazine.
Jacqueline Fellows is a contributing writer at HealthLeaders Media.