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A Culture Shift
Lindell is just one voice in a growing movement of more empowered patients challenging the age-old paradigm of Doctor Knows Best. “An empowered patient is someone who has figured out that healthcare is no longer best practiced in a paternalistic and beneficent way,” says Trisha Torrey, author of the blog Every Patient’s Advocate (www.everypatientsadvocate.com). “It means taking responsibility and collaborating with doctors to make the best decisions for you.” An empowered patient, she says, isn’t afraid to ask questions, seek second opinions, search for information online and—in some cases—question (without challenging) the doctor’s orders.
After decades of pushing by advocacy groups, the concept of a more consumer-based healthcare model has finally begun to take hold, even among healthcare providers. Although medical professionals many remain wary of the patient who arrives at an appointment with a list of questions and stack of Internet research, others are beginning to see the benefits of a more knowledgeable, engaged patient—not just for their own practice, but also for the healthcare system as a whole.
“Ideally, we’re working as a team—patient and doctor,” says Daniel Z. Sands, co-founder of the Society for Participatory Medicine. “We’re creating an environment where we’re sharing information [and] have better outcomes, lower costs and improved efficiency. To do so will require a culture shift, but it’s taking hold.”
However, to make Sands’s team concept a reality, patients must work hard to play their part. “Americans will not get their money’s worth for the $250 billion spent on prescription drugs in 2010,” says market analyst Miller. “The problem has little to do with the quality of the medications themselves, but rather how they are used, or not used.” In other words, patients must follow prescribed treatment regimens if they want effective and safe outcomes.
As Miller notes, “Study after study shows that only about half of people with chronic health conditions follow their physicians’ directions for care.” The so-called patient adherence depends on various factors, among them, the complexity of the drug regimen and the patient’s understanding of the reason for the medication.
Despite the array of challenges for patients to truly become empowered, the movement is spreading around the world. For example, “Euro Health Consumer Index 2009”—a survey of 33 European nations by the research group Health Consumer Powerhouse—ranked The Netherlands as having the most empowered patients in terms of patients’ rights, access to information, financial incentives and other indicators. Other top-ranked countries were Denmark, Iceland and Austria. The lowest-ranking ones? Bulgaria, Romania and Latvia—all regions where access to public healthcare remains a significant problem. Whereas government restrictions and lack of access to technology impede the empowered patient movement in developing countries, the biggest hurdle in the U.S., according to advocates, is a culture shift. “There are still a lot of people in healthcare who feel they should know everything, and that it’s better for a patient to just listen to the experts,” says Julia Hallisy, founder of the Empowered Patient Coalition. “But we are the best experts on our own bodies, and with cutting-edge information now at our fingertips, we need to start seeking it out and speaking up.”
Patients and their advocates have an unprecedented amount of information sources available to them. The nature and degree of proactive engagement in treatment options among consumers can impact the regulatory, discovery and business aspects of health.
© 2010 Scientific American,
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