The development towards empowered patients is the way to go. Studies show that patient engagement pays off in terms of quality of outcome, client satisfaction and costs. An example of this is this AARP study that showed lower readmission rates for chronic patients (USA). A recent Dutch study at UMC St Radboud shows that shared decision making can lower costs in IVF treatment. But a lot has to happen before the benefits of engagement can be enjoyed. How can doctors and patients each work towards empowerment?
Let’s start with some pointers for doctors.
1. Share your knowledge
The winner of the ZIP-talks for TEDxMaastricht 2011 says in his video: “Good information is also medication.” By sharing knowledge, trusting the patient’s capabilities of understanding difficult information, the doctor can create a level playing field. Patients can deal with ambiguities and probabilities of medical treatments. Ambiguity and uncertainties are part of every day life. By guiding them through the information and options, clarifying what is unclear, trusting them to make their own choices, he enables them to reckon with their health as they do in other parts of life. Shared decisions have a greater chance of a good outcome and customer satisfaction than unilateral decisions made by doctors.
3. Repeat your message with patience
Health care professionals can help patients by writing down advice and instructions, by providing pamphlets and website addresses with relevant information. Simply by repeating the message in different ways, the message has more of a chance to really land. Many of these resources are available online, just one printout away. Don’t get impatient when a patient does not comply immediately. Keep the bigger goal in mind while trying to make baby steps.
A doctor should always also direct a patient to other reputable sources of information, like relevant patient associations. Doctors and patient associations have a duty to translate relevant medical research into comprehensible formats. DiabetesFond started doing this with www.leesbaaronderzoek.nl.
4. Provide resources for ownership
To help a patient take ownership of his health, he should of course have full access to medical files, notes, lab results and appointment schedules. Offer online access to relevant medical professionals for urgent questions. If possible provide online platforms to share experiences with others. UMC St Radboud and Slingeland Ziekenhuis for instance have started with online portals that provide some or all these services for chronic patients. Patients can also be empowered in their own home: Personal Health Records or software systems that include self-monitoring with built in alarms; that offer domotics that enable the patient to be as independent as possible; that offer a comprehensive communications platform to share information and instructions amongst all people involved in the patient’s care.
What can patients do to empower themselves?
1. Take an interest
Don’t be just another lazy consumer. Take charge of your own health and disease. Read, gather information, ask questions. Become an active member of a relevant patient association or at least support them financially. Only then they can do their important work. Closely monitor policies of your health insurance company. You have the right to go elsewhere if they do not fit your needs or overcharge. Be open to e-health innovations that can make your life as a patient easier and help you to stay as independent as possible.
2. Give feedback, even when you’re not asked
Many people complain about health care professionals, but not TO them. How can you expect them to change if you do not tell them you are not satisfied? How can they improve their services if you do not tell them what you want and expect? Give feedback when you are happy or not happy with the service provided. Help others to find their way in health care by contributing your well-balanced feedback on platforms like ZorgkaartNederland.
3. Take responsibility
Don’t wait till you get sick. Take charge to stay healthy. Take full responsibility for your health by following lifestyle advice. Eat healthy, exercise; avoid too much stress, don’t drink too much alcohol and don’t smoke.
If you do get sick: Don’t take no for an answer when your doctor says he does not have time for questions. Don’t stop talking when he interrupts you after only 18 seconds of listening. Actively look for a doctor that takes you seriously. Ask for a second opinion if necessary.
OK, now your doctor has taken the trouble to involve you in the decision making process. Jointly you have chosen which way to go. Now it is up to you to stick to your choice. Take the medicine as prescribed. Do your exercises. Inform your doctor when you have unexpected problems. Don’t wait till they get out of hand. You and only you are in the end responsible for your own health.
This article was written for the website of TEDxMaastricht and published there on 02/03/2011.
© 2011 Harriët Messing