When Patients Train Doctors: Feasibility and Acceptability of Patient Partnership to Improve Primary Care Providers' Awareness of Communication Barriers in Family Medicine for Persons with Serious Mental Illness

Introduction: Excess mortality from physical chronic disease in patients with serious mental illness (SMI) is such that their life expectancy could be lessened by up to 20 years. This paper reports the results of a pilot study aimed at raising awareness among Primary Care Providers (PCPs) about communication barriers that stand in the way of the better integration of mental and physical health promotion and integration in Primary Care. Methods: We developed a small group learning script of medical training to be delivered by a health promotion nurse and a patient to address the diagnostic overshadowing phenomenon and positively change PCPs’ health promotion knowledge and attitudes. PCPs were asked to fill a series of questionnaires before and after the training. Results: 21 PCPs participated in the 60 minutes patient-centered training. Data shows a statistically significant change (p?.05) between baseline and follow up for 4 out of the 7 dimensions covered by the questionnaires: Health promotion capacity – Resources (p=.001), Psychological Medicine Inventory (p=.002), Efficacy of lifestyle counselling (p=.006), and Perception of skills at lifestyle counselling (p=.000). Discussion: Results suggest that it is possible to raise awareness about the diagnostic overshadowing phenomenon and change PCPs’ knowledge and attitudes by directly exposing them to the personal history of a person with SMI who acts as an auxiliary of medical education. Conclusions: Our script of medical training proved to be more effective than traditional simulation-based training, especially in terms of enhanced inter-professional collaboration. Primary Care Providers also learned that they can be supported by other professionals to whom they can refer their patients for health promotion counselling, and they learned how to better communicate from the patient who acted as an auxiliary of medical training.