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The complete guide to patient engagement for independent practices

Why is patient engagement important, and how can independent practices improve it? Discover essential patient engagement strategies and resources here.

Physician and patient discussing patient engagement strategies

At a Glance

  • Patient engagement, defined as patients feeling involved in, responsible for, and empowered in their healthcare journey, leads to better health outcomes, cost savings, and higher patient satisfaction.
  • There are 6 levels of patient engagement, ranging from informing patients to fully empowering them, and practices can implement strategies like clear communication, shared decision-making, and leveraging digital tools to improve engagement.
  • Measuring patient engagement through tools like the Patient Activation Measure (PAM®) and practice metrics is crucial, and patient engagement software can help independent practices meet patients’ expectations for a modern healthcare experience.

High levels of patient engagement are one of the most viable solutions we have to address the myriad of challenges in healthcare today. Engaged patients not only experience better health outcomes but also contribute to cost savings for themselves and healthcare organizations. Additionally, engaged patients report higher satisfaction with their care.

What is patient engagement? Simply put, it's when a patient feels involved in, responsible for, and empowered in their healthcare journey. 

In recent years, the concept of patient engagement has evolved significantly. Traditionally, patient engagement described the relationship between a provider and a patient. Today, it also refers to how involved a patient is in their healthcare beyond that relationship; for instance, how likely they are to proactively book appointments or adhere to care plans. 

Patient engagement is influenced by various touchpoints throughout the patient experience lifecycle. Every team member a patient interacts with plays a role in fostering this engagement.

To help healthcare providers, independent practice owners, and staff better understand why it matters, we’ve put together a comprehensive guide to patient engagement. 

Why is patient engagement important?  

Many patients today feel they are not meaningfully involved in their treatment plans or condition management. Some do not fully comprehend their diagnosis or treatment options, while others lack the necessary tools, resources, or knowledge to effectively self-manage their care between visits. A 2021 peer-reviewed article named ‘personal’ factors — including a lack of self-care knowledge and the difficulty of changing habits, as a top barrier among patients with heart failure.   

Patient engagement has been found to have many benefits for the patients themselves, as well as for the organizations that support and facilitate it. ”
Jan Oldenburg

“Patient engagement has been found to have many benefits for the patients themselves, as well as for the organizations that support and facilitate it,” says Jan Oldenburg, consumer health information strategy and personal health engagement expert, author of several books, and founder of Participatory Health Consulting.  

Engaged patients have higher quality care and cost less because they have the motivation, comprehension, and skills to adhere to their care plans. This engagement encourages proactive behavior in seeking appropriate follow-up care and maintaining a healthy lifestyle.

Patient engagement is closely tied to patient activation, which Judith Hibbard, founder of the Patient Activation Measure (PAM®) — one of the most commonly used methodologies used to assess patient engagement — described as “understanding one’s own role in the care process and having the knowledge, skills, and confidence to take on that role.” 

Engaged patients:

  • Understand their risk factors and conditions 
  • Know how to access their medical records 
  • Are comfortable asking questions 
  • Are confident making care decisions alongside providers
  • Proactively seek support and treatment

3 ways engaged patients fare better

  • Better adherence to treatment plans. More engaged patients are more likely to adhere to their treatment plans, i.e., take medications as prescribed, manage lifestyle factors, and seek preventative care, to lower the risk of complications. 
  • Less acute use. Studies have shown that more engaged patients have better health outcomes and lower acute care use. Conversely, other research shows that lower levels of engagement are correlated with more adverse health events. 
  • Reduced costs of care. Engaged patients reduce the costs of preventable expenses. They’re more likely to show up for appointments, communicate proactively with practices, and effectively self-manage, all helping to reduce healthcare costs for all parties involved. 
The importance of engaged patients
Patient Perspectives Report

What are the 6 levels of patient engagement?

Patient engagement is not a static measurement or a box to tick yes or no. Rather, there are various levels at which providers can work to engage patients in their own healthcare journeys. 

Based on the 6 stages of stakeholder involvement, which is often used in community advocacy and also the business and finance industries, the 6 stages of patient engagement are similarly a spectrum. Each step denotes greater patient involvement in one’s individual health.

  1. Inform. Providers share details by telling or informing patients about their health status, treatment options, and care plans. 
  2. Consult. Providers share information and solicit patient opinions, input, and preferences, but providers remain the primary decision-makers. 
  3. Involve. Providers more actively involve patients in a shared decision-making process. 
  4. Collaborate. Providers work alongside patients to collaboratively design treatment plans. Patients’ perspectives and preferences are fully integrated into treatment planning. 
  5. Partner. Providers and patients collaborate as partners to manage conditions and develop treatment plans. Patients participate as active partners to share decision-making alongside physicians and other members of the care teams. 
  6. Empower. Patients are fully activated and engaged in their healthcare. They proactively lead their healthcare journey and have the knowledge, confidence, and skills to self-manage their conditions and health. 
6 levels of patient engagement

How do patient engagement models correlate to individualized patient care?

More engaged patients are more activated in their own healthcare. These patients want and need a higher stage of involvement. They have the confidence, skills, and knowledge to want more agency in their own healthcare and treatment plans. 

When patients are more fully engaged in their own healthcare, they are more likely to advocate for their needs and share key details to co-design more effective and individualized patient care plans alongside providers, care teams, and caregivers. 

When patients are more fully engaged in their own healthcare, they are more likely to advocate for their needs and share key details to co-design more effective and individualized patient care plans alongside providers, care teams, and caregivers. ”

Additionally, at progressively higher levels of engagement, patients better understand their conditions. They also attain the health literacy to weigh options. Additionally, they are more likely to actively contribute to decision-making for care plans. 

What is collaborative patient care?

Collaborative care is the practice of including the various relevant and responsible stakeholders in a patient’s care plan, including patients themselves. This prioritizes patient involvement and can help increase patient engagement. 

According to a 2021 peer-reviewed article published in the journal Health Expectations, “In the last two decades, collaborative approaches have emerged, moving towards a logic of ‘care with patients’. For example, shared decision‐making encourages patients to take part in decisions on their care, while self‐management or patient education approaches seek to strengthen patients' knowledge and skills to better empower them in their care process.”

For instance, a clinician could incorporate the patient into shared decision-making during a consultation to better determine a treatment path that resonates with the patient's values, objectives, lifestyle, and capacity. 

As another example, a front staff member might assist a patient in understanding how to use their patient portal to submit questions and review lab results. Similarly, a care manager could work alongside a patient outside appointments to boost health literacy. 

Give patients the experience they deserve with streamlined access to records, messaging, results, and more. Request a demo of Tebra’s patient portal today.

In what ways can patient outreach help with patient engagement? 

Taking proactive steps to reach out to patients can play a central role in their care journey. By connecting with patients outside the clinical setting — whether through email, text, or phone calls — healthcare providers can establish relationships and potentially elevate patients' involvement in their own healthcare experience.

Patient outreach allows practices to keep patients active in their own health journey. ”

Patient outreach allows practices to keep patients active in their own health journey. This multi-touch approach keeps care plans top-of-mind for patients and supports some aspects of patient engagement, like showing up for appointments and sticking to medication regimes. 

Patient outreach includes: 

  • Reminding patients about upcoming appointments 
  • Sending intake forms in advance 
  • Sharing post-appointment care instructions and summaries
  • Requesting patient feedback
  • Launching digital marketing campaigns and strategies to keep your practice top-of-mind 
  • Sending thank you notes
  • Sharing seasonal greetings
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What are the ways patient engagement motivates patients? 

The more engaged patients are, the more likely they are to be self-motivated in their healthcare. A 2020 peer-reviewed study noted that the “engaged patient has a strong motivation to become more knowledgeable and more powerful.”

This could be because the same techniques that help support patient engagement — active listening, open-ended questions, affirming a patient’s perspective — help emphasize a patient’s intrinsic motivations in care conversations. Once a clinician has identified what those motivations are, they are better able to work alongside patients to co-create care plans and make decisions, which can help promote shared decision-making. 

The process of advancing through the 6 steps of patient engagement can serve to motivate patients, too — as they acquire more knowledge, skills, and confidence. 

How does patient engagement affect patient outcomes? 

Higher rates of patient engagement — when a patient feels involved in, responsible for, and empowered in their healthcare journey — are positively correlated to patient outcomes. 

Part of this has to do with the proactive role more engaged patients take in their care, which supports shifting from a focus on a health issue to a focus on recovery and prevention. 

Higher rates of patient engagement are positively correlated to patient outcomes. ”

“One of the benefits of shifting from a disease focus to a health focus is that you can engage people in their care before it becomes critical. That means people are under less stress and are more likely to be able to process the information,” says Oldenburg. 

Doing so can also lead to a sense of agency, which may help support patients' adherence to their health plans. “Health and lifestyle choices also may feel like areas where people are better equipped to participate in the plan of action and modify it to suit them, which builds empowerment and engagement that translate into the health decisions,” Oldenburg says. 

Patient engagement supports the triple aim

“Patient engagement, especially when supported by digital tools that simplify engagement, has been found to positively impact all dimensions of the ‘triple aim,’” says Oldenburg, referring to IHI’s triple aim of improving the patient experience of care, improving the health of the population, and reducing per capita cost of care for the benefit of communities. 

Oldenburg elaborated with the following examples:

  1. Improved quality of care. The more engaged patients are, the better care they’re likely to ensure for themselves. For example, “People who are more engaged are more likely to find errors in their medical records. They are also more likely to be up-to-date on preventive services and be adherent to their medication or treatment plans."
  1. Cost savings. Better patient engagement means better patient outcomes, which can result in cost savings for all. “Patients who are engaged with their health can save themselves — and the health system — money. They’re more likely to show up for visits. When patients use self-service tools for self-scheduling or bill pay, the physician’s office may be able to spend less on office staff. Patients who are engaged are more likely to be thoughtful about extra services,” says Oldenburg.
  1. Greater satisfaction. Engaged patients are more likely to be satisfied with their care and outcomes. “Rather than having healthcare ‘done to’ them, they are more likely to feel as if it is ‘done with’ them, and that can make a tremendous difference in loyalty and satisfaction,” Oldenburg adds. 

What can go wrong if patient engagement is neglected during any stage (pre-care to post-care)? 

Failing to support patient engagement creates issues across the patient journey. 

Pre-care

When patient engagement is neglected during pre-care, patients may fail to come prepared for appointments or miss appointments entirely. 

Without sufficient information shared ahead of time, they may, for example, fail to fast before blood work, forget to bring necessary medical equipment, or fail to show up altogether. 

During appointments

If providers fail to prioritize patient engagement during appointments, patients can miss key details about their diagnosis, care plan, or treatment options. This makes them unlikely to be active partners in care plan decisions.

Moreover, if patients don’t feel open discussions are welcome, they may avoid asking clarifying questions or requesting more information. “In patient communication, it’s really important to make it clear that questions and discussions are welcome. A clinician who is impatient or abrupt with patient questions is not engaging, and people have to be brave to continue in the face of that attitude,” Oldenburg says. 

Patients who feel neglected during appointments may leave the practice. ”

Critically for independent practices, patients who feel neglected during appointments may leave the practice. Tebra’s 5th consecutive Patient Perspective survey found that 47% of patients surveyed said they left a practice due to poor experiences with the provider. 

Post-care

If patient engagement is neglected post-care, patients may fail to adhere to their treatment plans or otherwise experience poorer outcomes. They may fail to make the appropriate follow-up appointments, pick up new prescriptions, or miss payment deadlines. 

Poor patient engagement can even be linked to lower reimbursement rates in the value-based reimbursement model. 

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How each staff member in the patient’s journey can have an effect on desired outcomes

Each member of your practice’s team plays a role in supporting patient engagement. The attitude, competencies, knowledge, and empathy of team members, from front office staff to providers, can have an effect on desired outcomes. 

“Everyone on staff has a role to play in creating a consumer experience that is warm, engaging, and (especially important) not condescending,” says Oldenburg. 

A positive patient experience with practice staff can support engagement in its many facets. For example, a kind staff member that demonstrates the utility of a patient portal can encourage patients to sign up. 

A positive patient experience with practice staff can support engagement in its many facets. ”

Oldenburg notes that phlebotomists are often the best ambassadors for a patient portal. “They can say things like, ‘And if you want to see these lab test results faster, sign up for the patient portal and you’ll see them as soon as they are available,” she says. 

Here's a checklist for ensuring positive patient outcomes in your practice: 

Front office

  • Set up auto-reminders for patient appointments 
  • Share digital intake forms and review for completion in advance of patient visit
  • Cultivate a warm, friendly, and welcoming ambiance for receiving patients
  • Share clear billing or payment instructions
  • Request patient feedback

Medical staff

  • Complete any required pre-visit communication
  • Promptly respond to questions received via phone call, text message, or patient portal 

Nursing staff

  • Assess patient engagement and health literacy to inform healthcare team educational strategies 
  • Provide an overview of what was discussed in previous visits
  • After the provider visit, reiterate diagnosis, prognosis, and treatment plan 

Primary care providers

  • Practice active listening with patients
  • Use clear, simple language when educating patients and demonstrate empathy 
  • Invite questions and discussion
  • Engage patients in shared decision-making

7 patient engagement strategies independent practices can implement

Read on for clear guidance on how practice managers and practice owners can enhance patient engagement today.

1. Assess patient engagement 

Use the patient activation measure (PAM®) for a baseline understanding of patient engagement. PAM® provides a numerical measure that assesses patient activation on a scale from “disengaged and overwhelmed” to “maintaining behaviors and pushing further,” which allows providers to tailor communication and care plans and increase patient engagement. 

Numerical scale for the patient activation measure (PAM) to assess patient engagement
Source: www.insigniahealth.com/pam/

2. Clearly communicate to patients

Communication requires as much listening as speaking. Practice active listening with patients to make them feel heard and gather as much information as possible. 

Avoid medical jargon, clearly explain topics, and be sure to offer written instructions in the patient’s native language when possible. For more information, look into the American Academy of Family Physicians’ 4 evidenced-based communication strategies for patient care

3. Engage patients in shared decision-making

Engaging patients in shared decision-making ensures that their preferences, values, and goals are an integral part of determining their care and treatment plan. By working closely with providers, patients take an active role in creating personalized care plans and treatment strategies tailored to their unique needs and circumstances, which can increase patient buy-in, too. 

4. Leverage digital tools 

When it comes to healthcare, patients are eager for the same consumer experiences they’re accustomed to in other parts of their day-to-day lives. Practices can automate the admin of patient interactions in the digital sphere to streamline the patient experience. 

Practices and patients benefit from digital tools like online scheduling, digital patient intake, automatic appointment reminders, and post-visit reminders. ”

Practices and patients benefit from digital tools like online scheduling, digital patient intake, automatic appointment reminders, and post-visit reminders. 

Leveraging digital tools also frees up provider time so they can dedicate more of their schedule to patient care. Tebra’s 5th consecutive Patient Perspective survey found that 61% of providers surveyed reported spending 5-19 hours on administrative tasks each week.

5. Offer telehealth appointments

Part of engaging patients means meeting them where they are. For many patients, a visit to the office isn’t necessary or convenient. Patients consistently say they want access to telehealth. The same Tebra survey found that 53% of patients surveyed said they prefer virtual appointments for convenience and time-saving. 

Telehealth appointments and virtual screening options can be a cost-effective way to deliver timely, quality care to a wider swath of your patient population. 

6. Request feedback for improvement 

Request feedback to collect valuable patient testimonies. This also helps you to gain actionable insight into the patient experience, and offers patients a chance to share their experience. 

7. Offer post-visit care

Patients often struggle to adhere to their medication regimen, care plans, or recommended behavior modifications. Patient portals or text messaging can support practices in maintaining an open line of communication to encourage patients, provide positive feedback, and answer any questions. 

Patient portals or text messaging can support practices in maintaining an open line of communication to encourage patients, provide positive feedback, and answer any questions. ”

A 2022 study published in JAMA found that patients who opted in to a text message patient outreach campaign had a 41% decline in their risk for readmission within the next 30 days. 

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What are the best ways to keep patients engaged? 

Working to keep patients engaged in their healthcare journey is a practice-wide effort. Train team members on these strategies as best practices. 

Improve communication

Effective communication is crucial for patient engagement. By practicing active listening and demonstrating empathy, healthcare providers can create a foundation of trust, which can encourage patients to share concerns more openly. 

But it’s not just provider-patient communication that matters. Practices should also coach staff members on patient communication skills, emphasizing empathy, compassion, and conciseness in their interactions. 

Provide education

For all patients who are actively engaged in their healthcare, providers must take the time to provide comprehensive guidance and information about health conditions, treatment options, and potential outcomes. 

We know that patients often turn to the web to seek medical information, which isn’t necessarily a bad thing. The authors of a 2022 peer-reviewed article write that “a patient acquiring new knowledge through online reading is in the process of patient empowerment. The focus here shifts to activities and inputs that increase the patient’s ability and motivation.” 

Higher levels of patient education make it more likely patients will be able to act as informed partners in care decision-making. However, it’s critical that medical providers address any misconceptions or concerns patients may encounter online to ensure patients have an accurate understanding of and adherence to recommended treatments.

Foster shared decision-making

Collaborative decision-making between healthcare providers and patients is key to patient-centered care. Recognizing that patients possess unique insights into their own lives, preferences, and values, providers should consider patients’ individual circumstances while engaging them in discussions about treatment plans. 

Collaborative decision-making between healthcare providers and patients is key to patient-centered care. ”

By involving patients in decision-making processes and respecting their autonomy, providers and staff can foster a sense of ownership and commitment to treatment plans, leading to increased engagement and adherence.

Empower self-care

Empowering patients to take an active role in managing their health outside of clinical settings is essential for sustained engagement. Setting collaborative goals tailored to each patient's needs and preferences encourages the adoption of healthy habits and behaviors. Regular follow-up appointments provide opportunities to assess progress, address challenges, and reinforce positive behaviors. 

Teaching self-monitoring techniques enables patients to track their progress, recognize improvements, and promptly address any concerns, fostering a sense of control over their health outcomes.

Utilize technology

Leveraging technology to enhance patient-provider communication and access to care is paramount in modern healthcare delivery. Implementing intuitive patient portals, digital billing systems, and online scheduling platforms improves convenience and accessibility for patients. 

Additionally, utilizing messaging systems allows for efficient communication and timely responses to patient inquiries, enhancing overall satisfaction and engagement with healthcare services.

Integrating technology, like patient engagement software, into practice operations not only streamlines administrative processes but also facilitates meaningful patient interactions, ultimately improving engagement and outcomes.

Ways to keep patients engaged

Discover how Tebra’s automation solutions help you improve the patient experience, save time, and streamline your practice.

How do private practices know if their patient engagement strategies have been successful?  

While other measures exist, PAM® is perhaps the most common way physicians assess patient engagement. Developed by Judith Hibbard, Ph.D in 2004, PAM® “has been used in a wide variety of studies that show that more highly activated patients, as measured by the PAM® score, correlate to better healthcare outcomes, lower costs, and higher satisfaction with the healthcare system,” writes Oldenburg in the chapter Personal Health Engagement in Medical Informatics

PAM® is perhaps the most common way physicians assess patient engagement. ”

According to the Patient Safety Network, physicians can use PAM® to determine patient activation and assess where the patient is at with health activation, which is necessary for patient engagement. 

Additional ways to measure patient engagement

Other ways to measure patient engagement in healthcare include looking at practice metrics. For example, the following indicators can provide some measure of patient engagement: 

  • Portal enrollment and usage. Patients want portal access and statistics show usage is increasing. If portal enrollment and use at your practice aren’t up, better education strategies may be needed.  
  • Website traffic. Traffic to your practice’s website is another way to measure engagement with patients. Look at metrics such as: How many people visit your website monthly? How long do they stay? What information are they looking at or searching for? Are your numbers going up or down? 
  • Unpaid balances. Post-visit patient engagement can be tied to unpaid balances, so be sure to make the billing process as easy as possible and train staff on communication around price transparency, upfront collection, accurate billing, clear and concise billing statements, and online bill pay. 
  • Patient cancellation rates. Cancellation rates can provide a valuable starting point for further investigation of patient engagement. Cancellation rates may be high because wait times are long or because patients don’t have an easy way to reschedule instead of canceling appointments. 
  • Formal complaints and grievances. Poor reviews or formal complaints are clear indicators of your practice’s level of engagement with patients. To remedy concerns and combat reputational damage, be sure to reply to all online reviews, positive or negative.  

How can patient engagement software help independent practices with patient care?

Every team member has a role to play in fostering patient engagement, but the ultimate goal is to empower patients to proactively self-manage their own health. As such, it’s important to remember that patient engagement comes in many forms. Taking a patient-centric approach to engagement means meeting patients where they are. 

This extends to communication preferences, and practices need the digital tools that deliver the consumer experience patients expect, whether that’s through text messaging, a patient portal, or digital app. 

To this end, practices are increasingly turning to technology — like patient engagement software, patient portals, online scheduling/reminders, and patient-accessible medical records and results — to support engagement and care. 

Emerging research highlights strong correlations between the use of digital tools and health engagement rates. ”
Jan Oldenburg

“Emerging research highlights strong correlations between the use of digital tools and health engagement rates,” writes Oldenburg in Medical Informatics. Higher rates of patient engagement in healthcare can lead to better patient-provider relationships, leading to better health outcomes. “When digital tools are used effectively, they can increase the partnership between patients and their clinicians while contributing to positive health outcomes.“

Patient portals, in particular, are shown to be a promising tool in the patient engagement arsenal. A study from the University of Pennsylvania Health System “showed that patient portal use had a significant positive impact on patient adherence to preventive measures,” writes Oldenburg. 

Additionally, a meta-study review of 170 papers “showed that ‘Overall, 88.8% (151/170) of studies showed positive impact on patient behavior and 82.9% (141/170) reported high levels of improvement in patient engagement,’” she writes.

What patient engagement platforms or software are best? 

The search for a patient engagement platform can be overwhelming, given the sheer number of options available. Below, find some of the leading patient engagement solutions on the market today. 

Birdeye is a patient engagement software and digital reputation platform for independent practices. Birdeye enables practices to automatically request patient reviews and feedback and engage patients online. 

Artera is a patient engagement platform that leverages AI to engage in HIPAA-compliant conversations with patients. Practices can use Artera to automatically triage inbound patient communications for better patient engagement.

Tebra is the leading patient engagement platform for independent practices, offering an all-in-one practice management software that enhances patient satisfaction, improves engagement at every touchpoint through the care journey, and provides a competitive edge with tools tailored to meet unique patient needs.

Tebra is the leading patient engagement platform for independent practices. ”

Praxis is an EHR software for orthopedic practices that offers significant time savings in charting, allowing providers to dedicate more quality time to their patients. The template-free design of Praxis allows physicians to be flexible and personalize care for each patient.

Clinicea is dermatology patient engagement software that supports practices with clinical workflows, appointment scheduling, patient data management, and more.  

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What resources can private practices use to improve patient engagement? 

There’s a lot to cover when it comes to patient engagement. In addition to the information shared here, the following resources may be helpful as your independent practice focuses on patient engagement. 

  • The Patient Engagement Playbook by the Office of the National Coordinator for Health Information Technology (ONC) provides comprehensive information on how technology can support patient engagement. The playbook is especially useful for clinicians wanting to leverage patient portals to increase patient engagement. 
  • AHRQ provides a number of free tools to support patient engagement, including resources for providers, patients, and families. They also offer a helpful PDF aimed at supporting patients and family engagement in hospitals, but many of the tips are applicable to independent practices, too.  
  • The CDC’s patient engagement page as part of their health literacy series provides research-backed information and actionable tips. Their website also makes it easy to access other resources on adjacent topics. 

Allow your patients to be more engaged and proactive in their care with Tebra's intuitive, all-in-one platform. Learn how you can streamline tasks, simplify scheduling, and hear directly from your patients. Book a demo today.

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Catherine Tansey, business writer and reporter

Catherine Tansey is a business and healthcare writer and reporter. She has close to a decade of experience writing and reporting on small business best practices, emerging technology, market trends, and more. Catherine has several family members who own private practices in mental health services, dentistry, and chiropractics, and she’s seen firsthand the pride and privilege practice owners feel to be able to support their communities.

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Lauren Wheeler, BCPA, MD

Dr. Lauren Wheeler, MD, BCPA, is a former family medicine physician who currently works as an independent healthcare advocate as well as a medical editor and writer. You can get in touch with her about anything writing or advocacy at her website www.lostcoastadvocacy.com.

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