AIDET for Physicians

“Curmudge, I think you made a poor assumption a week ago when you said that everyone had already learned about AIDET from Studer’s book (1).”

“If so, Jaded Julie, it wouldn’t be the first time. When I first taught general chemistry in 1965, I assumed that all of the students could work with logarithms on a slide rule.”

“(Logarithms? Slide rule? What’s the Old Guy talking about now?) So what did you do?”

“We taught people what they needed to know, and that’s what we’ll do here. Of course, the blog limits how much detail about AIDET we can provide. The quoted material will come from Beeson’s book (2), and imperative statements should be considered to be directed to the physician.”

Acknowledge

Confer with the nurse and/or review the patient’s chart before entering the exam room.

Make eye contact with the patient and any relatives in the exam room. The relative may be your main ally in understanding and implementing your plan of care.

Introduce

Introduce yourself and describe your exact role in the care of the patient (especially when entering an inpatient hospital room).

In your first encounter with a patient, describe your experience and expertise. This will reduce the patient’s anxiety and increase her confidence in you.

“Manage up” (a Studer term). Express your confidence in the other members of the care team.

Duration

To the greatest extent possible, keep the patient informed regarding the length of a procedure, when test results will be available, the length of stay in the hospital, and any other wait times.

Explanation

Areas requiring explanations include diagnosis, medications, treatment options, and follow-up care.

If the diagnosis is not definitive, provide a list of possibilities. Explain the nature of tests to be performed and what is being sought. “A patient’s diagnosis ignorance creates treatment indifference and compromises compliance, and can unravel evidence-based treatment plans.”

“It has been shown that those patients who understand the purpose, potential side effects, duration of therapy, and anticipated outcomes of medications are more likely to take them.”

“Physicians should convey their (treatment) recommendation based on evidence.”

Thank you

“I’m glad you came in today; I know we can help.”

“As you recommended, Curmudge, I skimmed through Beeson’s earlier book, Practicing Excellence (3). To my surprise, AIDET wasn’t there.”

“The lessons for physicians were there all right. They just had not been collected into the AIDET acronym. Practicing Excellence is a must read for physicians.”

“Curmudge, the advice from Studer and Beeson is really essential, but it’s not going to happen unless it’s hardwired.”

“Don’t worry, Julie. Once physicians become convinced that something is important, they are the world’s experts at hardwiring. In addition to Beeson’s comments for physicians, here is his suggestion that all of us should hardwire:

‘Eye contact, a smile, and a ‘hello’ from everyone wearing an ID badge as patients and families walk your facility creates a favorable impression and speaks to the character of the institution.’”

Affinity’s Kaizen Curmudgeon

(1) Studer, Quint. Hardwiring Excellence. (Fire Starter Publishing, 2005)
(2) Beeson, Stephen C. Engaging Physicians: A Manual to Physician Partnership. (Fire Starter Publishing, 2009)
(3) Beeson, Stephen C. Practicing Excellence: A Physician’s Manual to Exceptional Health Care. (Fire Starter Publishing, 2006)