On a recent sunny, fall afternoon, Hector and the pharmacist at Open Arms Free Clinic watched a drop of Hector’s blood seep down the test strip into a glucometer and waited for a number to appear on the display.
Hector had recently started checking his blood sugar several times a day, and he didn’t think his machine was working properly. Worried, he called the clinic and one of the helpful Patient Service Representatives set up an appointment for him to visit with Meagan, the clinic’s pharmacist.
At his appointment, Hector met with Meagan, who walked him through the steps of using the machine. Then it was Hector’s turn to practice by testing his blood sugar. When the number finally appeared, it was 227 – higher than usual for a random blood sugar test, and a red flag for Meagan.
ASKING QUESTIONS FOR BETTER UNDERSTANDING
Blood sugar levels can vary widely depending on a number of factors. A reading over 200 is always a call for further investigation, so Meagan probed a bit.
As they talked, she learned that Hector had not eaten since lunchtime. He shared that he had eaten only two small tamales for lunch. She was puzzled. It was long past lunchtime, so it probably wasn’t his lunch that was causing the high reading.
Curious to know more, Meagan dug a little deeper. “What about things to drink?” she asked.
Hector told Megan he drank large amounts of jamaica water during the day, a drink his wife prepared for him. It was water, he reasoned, and he didn’t add sugar to it, so it seemed like a good thing to drink.
Unfamiliar with this drink, Meagan asked her patient to wait while she went to connect with her teammates in the clinic. She needed to learn more about jamaica water and where it fit into Hector’s blood sugar story.
TAKING TIME TO UNDERSTAND THE WHOLE STORY
Meagan asked a few clinic staff members at the discharge desk if anyone had heard of jamaica water. Marisol, the clinic’s Clinical Care Coordinator, was able to offer some insight.
Jamaica water, according to Marisol, is another name for hibiscus tea, a common drink for many Hisapanic families from Mexico. A little research into the ingredients revealed that it was a tea made from dried hibiscus flowers and sweetened with sugar.
Hector might not have been adding his own sugar to the drink, but it was likely there was sugar added to the drink when it was made. If he drank a lot of it everyday, the two reasoned, it might be enough added sugar to cause higher than normal blood sugar readings.
Meagan returned to the exam room and spent a few more minutes talking with Hector about the things he was eating and drinking before she sent him on his way.
He left the clinic armed with additional knowledge that could help him better control his higher than normal blood sugar. He had learned a possible cause of his elevated blood sugar readings. And with the skills needed to take more accurate blood sugar readings, he was more empowered to use those readings to better understand how the food and drinks he consumed impacted his blood sugar.
A SCARCE AND VALUABLE RESOURCE
In healthcare, as in life, time is a scarce and valuable resource. It’s often carefully rationed to provide service to the greatest number of patients in the least amount of time. While it maximizes profits, this approach limits the time patients have to ask questions and learn what they need to become their own best advocates.
At OAFC, the approach is different. Time is still scarce, but it’s valuable for a different reason. The time providers spend with their patients is considered a crucial investment in the patient-provider relationship.
This perspective transforms each interaction between patient and provider from a billable transaction to a step in relationship building. Time allows providers to meet patients where they are, builds trust between patients and providers, and nurtures relationships in which the patients are accompanied by providers on the path to better health and wellness.
Hector and his healthcare providers might never know the exact cause of his high blood sugar reading on that particular sunny, fall day. But the small amount of extra time Hector spent with the providers at OAFC raised the level of understanding of patient and providers, while strengthening a relationship crucial to Hector’s continued good health.
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