A Physician Assistant’s Take on Direct Patient Communication
By Deborah Dropcho, PA
Deborah Dropcho, PA

After initial introductions with my new PA students, I always present them with my opening question.

“What is the single greatest thing you can provide your patients?”

Answers range from basic to insightful. Compassion and advocacy are two that I now hear often.

The answer I am looking for is quite simple; Education.

I tell both patients and students alike that if a health care provider does not educate their patients about lifestyle modifications; they are doing them a disservice. 

By neglecting to address prevention as the primary focus of healthcare, we are failing our patients, and we are failing ourselves. We continue to practice “sick care,” disregarding modifiable risks such as alcohol consumption, diet, sleep hygiene, and stress management. 

According to the American Institute for Cancer Research, the single best way to lower the risk of cancer is to have a healthy diet. They define a healthy diet as a variety of plant-based nutrients, avoiding or limiting the amount of processed foods, red meats, and sugar-sweetened drinks consumed. Despite this, the American Cancer Society reports that excess body weight causes almost 8% of all cancers (and more than 6% of all cancer deaths). Furthermore, the National Cancer Institute estimates alcohol-related cancer deaths at 3.5% with a 5% overall cancer risk associated with all types of alcoholic drinks.

Alcohol is a known Group 1 Carcinogen and a dependence-producing substance with a Margin of Exposure ranging from 3.1 to 0.8 for heavy drinkers, yet some providers fail to address it in any meaningful way during visits. They accept when a patient states they drink “socially” but they don’t investigate if that means one episode of binge drinking monthly or 3 glasses of wine every single day of the weekend.  

Despite the American Academy of Sleep Medicine’s recent “Defend your Sleep” and “Sleep is Good Medicine” campaigns, most of my patients have never been educated in sleep hygiene.  This includes basic yet critical behaviors like going to bed and, most importantly, waking up, at the same time every day. An emphasis is made on exercise when discussing healthy lifestyles, yet all of your body’s restorative and healing processes occur while resting.  

With our current healthcare model, unfortunately, the largest hurdle to implementing meaningful lifestyle modification interventions will be time. Incorporating simple questions regarding sleep and lifestyle into our daily interactions will require compassion, finesse, and practice if it is to be successful. Perhaps we can start making small changes in how we address and approach these subjects with our patients. However, if we hope to affect cultural change, the most important action will be how we incorporate and exemplify these concepts ourselves.

Deborah Dropcho is a PA located in Ohio specializing in Otolaryngology.

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