Dr. Gates is Talking About...Teach Back

March 17, 2023

The following piece was written by Wood River Health's Chief Medical Officer Dr. Jonathan Gates and published in the Westerly Sun in March 2023.

There are many “months of” and “weeks of”, but I’d like to call your attention to Patient Safety Week this March 12 to 18. While we are all familiar – even to the point of not thinking about what life was like before – with safety interventions like seat belts and smoke detectors, it turns out that in practice it is usually very difficult to make such simple changes that dramatically improve safety. In fact, after seat belts were required, there was a small increase in the number of car accidents – people felt, and were, safer, so they paid just a little less attention to the road. Deaths, however, declined much more.

In healthcare, the situations we find ourselves in are incredibly complicated, both because of that which is unknown at the time of required treatment, and because the treatments themselves come with pros and cons. Providers of all kinds must navigate these uncertainties, calling upon their extensive knowledge and experience, and doing their best to avoid making errors in the process.

To deliver the highest quality of care, providers must actively listen to their patients and bring them into the decision- making process about their treatment. Communication is at the heart of the majority of preventable errors in healthcare – if you haven’t read Dr. Atul Gawande’s Checklist Manifesto, it is a good place to start.

What steps can patients take to improve their personal health and safety? It is a simple practice, but it is very effective in preventing errors in following a treatment plan. It’s called “teach-back”. The process is simple. Just repeat back to your provider what you heard them tell you to do. This includes their instructions, how to take the medications they prescribed, and their recommended course of treatment. It’s that simple. Why? Studies show that in the hospital setting 70-90% of what is said to patients goes unremembered. Primary care is probably better, but even at half this rate, there is room for improvement.

The next time you see your provider, pay attention to whether they are using teach- back. If they don’t, initiate the process. All you have to say is, “I just want to repeat back what you said so I get it right”. Your provider wants you to “get it right”. And they will see you practicing teach-back as sign of taking charge of your own health.

Patient Safety Week serves as a good reminder that you and your provider share the same goal: to keep you healthy and safe. Practicing teach-back will help you both to achieve this.

About Dr. Gates

A South County native, Jonathan Gates, MDCM has served as Wood River Health’s Chief Medical Officer since January 2023. He trained at McGill University Faculty of Medicine and completed residency at Maine Medical Center in Portland, Maine. Board certified in Internal Medicine, he formerly served as Chief Medical Officer for Accountable Care at Providence Community Health Centers. During his tenure, Dr. Gates garnered over $24 million in net-new Medicaid revenue for the center while increasing patient safety and equity of health care access using proactive care management and flexible processes for primary care teams.