The Power of Trust: Transforming Healthcare at the Kitchen Table

I recently met with an advanced practitioner pharmacist in geriatric care. She was a true expert, and she spoke insightfully about how often physicians have an incomplete picture of the patient’s medication regimen. They’re deeply familiar with the medications, of course, but quite often they simply do not know how or how often patients are actually using them. They’re also frequently unaware of other supplements and drugs patients are on, and the potential dangers of interactions between these treatments.

It struck me that physicians indeed cannot really know these things unless they’ve developed a profound level of trust with the patient. And it also struck me that there may be no more powerful indicator of the value of home-based primary care than this. 

When one of our physicians knocks on the door of a patient’s home, they are quite literally seeking humble permission to enter the patient’s world. They are an invited guest; there on the patient’s terms, on the patient’s turf, with all the implicit covenants that pass between a host and guest. 

The hosts have done their best to graciously provide a welcoming environment, and the guests will do their best to absorb that grace and return it in kind. Consider the level of trust that’s wrapped around that entire process – on both sides, but especially on the part of the host.

Our physicians understand this implicitly and have therefore made it their practice, when at the front door, to ask patients and caregivers where they’d feel most comfortable having a conversation or an examination. Often that conversation happens in what I like to think of as almost sacred family space: the kitchen table, where so much of family life unfolds.

When you’re in that place, you absorb a person’s life context – family photos on the wall, religious celebrations nearby, inspirational quotes and crayon drawings from grandchildren on the fridge. Then, in the center of it all, at the kitchen table, comes a health-related conversation that almost inevitably includes mentions of what matters most to patients. Their people. Their passions.

Not just their health, but their life.

Our physicians take immense joy in these visits because these are not ordinary clinician-patient interactions. They’re human connections. And they also happen to make the physician-patient interaction exponentially more effective.

Take for example a recent story from Dr. Michael Wang, one of our team’s geriatric specialists. While visiting the home of a new patient, he asked a family caregiver to see all of the patient’s medications and supplements. He produced not just the medications, but a beautiful color-coded schedule of everything he was taking. It was a well-earned point of pride for the family.

Dr. Wang soon prescribed new medications for the patient’s heart condition, but during a follow-up visit, he could sense something was amiss. Over a conversation at the kitchen table, they shared the fact that, with the new medications now in his regimen, the patient needed to take a pill every 2-3 hours around the clock.

It was hard for them to admit, but they’d simply been unable to keep up.

Dr. Wang promptly changed the medications to stretch the time between dosages to six hours. The patient’s condition quickly improved – no doubt along with the patient’s and family’s sleep.

While such conversations can conceivably happen in a busy doctor’s office, they typically do not. It takes time to even explore such topics, and it takes a relationship built on trust for patients and caregivers to admit that they may be falling behind on treatments or medications.

There’s often shame in that struggle – and little wonder, given that patients earn the label “non-compliant” in such situations. It’s the view of our clinicians that you can only overcome that dynamic by genuinely presenting as a trusted partner in a patient’s care, not someone simply dictating treatment terms.

The best clinicians in the industry, of course, somehow find ways to build that level of trust even when operating in inhospitable situations. But we at Welcome Health are proud to say that we’ve built a practice in which we continually earn our place at our patients’ kitchen table. And in exchange for that trust, we receive the joy of knowing that we can make a greater difference in their lives and the lives of their caregivers.

If you’re curious to learn more about these and other ways we prioritize trust, with patients, team members, and business partners, please reach out. We’d love to tell you more.