Do you recall a time when you knew what you should do, knew all of the intellectually sounds reasons to do it, and yet still didn’t take any action?
You’re not alone. Welcome to the state of Clinical Inertia.
What is it?
William Strain, MD, and colleagues define clinical inertia as, “the failure to establish appropriate targets and escalate treatment to achieve treatment goals. It accounts for a significant proportion of failure to achieve targets in the management of diabetes and contributes to up to 200,000 adverse diabetes- related outcomes per year.”1
Strain refers here to clinicians’ tendency to hesitate or wait longer than is appropriate before advancing therapy, despite documented lack of clinical progress. But patients, too, fall prey to their own variety of clinical inertia.
How can you help them combat it?
1. Cultivate your curiosity.
Like the medical detective you are, ask questions to delve deeper into why your patient has been hesitant about changing his or her regimen, or has not been improving. One of my mentors, Steve Edelman, MD, who is both a renowned endocrinologist and has been living with type 1 diabetes since the age of 15, advises, “I like to start by asking, ‘What’s bothering you most about your diabetes?’” What we often label as frustrations or pain points, can just as often be springboards to innovative solutions.
Next: Partner with your patient
1. Strain WD, Blüher M, Paldánius P. Clinical inertia in individualizing care for diabetes: is there time to do more in type 2 diabetes? Diabetes Ther. 2014;5:347–354.