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The Rise of the Empowered Patient

Once marginalized, consumers are taking more control over their own treatments

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Rise of the Empowered Patient

Seeds for Change

In a healthcare system that has for so long encouraged patients to be passive, how can putting them at the center of decision making benefit the system as a whole? One advantage is better outcomes. The “National Healthcare Quality Report, 2009,” produced by the U.S. Department of Health and Human Services’ Agency for Healthcare Research and Quality, states that patient-centered approaches improve patients’ health status, lessen symptom burdens and “can reduce the chance of misdiagnosis due to poor communication.”

In some cases, providers already see the potential value of collaborating with patients on healthcare options. For instance, Miller points out, “Three dozen hospitals and clinics—including Fox Chase Cancer Center, Kaiser Permanente and the UCLA Medical Center, in conjunction with the Foundation for Informed Medical Decision Making—have recently launched clinical demonstration sites with the mission of amplifying the patient’s voice in healthcare decisions. The patients-as-partners model is sometimes referred to as Health 2.0.” Such shared decision making, Miller asserts, could save billions of dollars annually, because studies show that it leads patients to choose conservative and less costly treatment options more often. “For instance,” he continues, “when patients with herniated discs were shown a video explaining that similar outcomes could be expected whether they have surgery or not, rates of spinal surgery at Dartmouth-Hitchcock Medical Center dropped 30 percent.”

Time management is another consideration. As Hallisy, who is a dental practitioner, notes, “A patient who comes in prepared, engaged, aware of his or her symptoms and ready to ask questions makes for a much more timely and efficient office visit.”

“It’s true that the majority of my colleagues consider themselves in the old camp, where it’s up to us to give the orders,” says Charles Smith, a long-time family physician and founder, chairman and medical director of eDocAmerica, a Web-based provider of doctor-consumer consultations online. “My personal view is that the only way patients can obtain an optimum outcome is to take responsibility for their own healthcare. We’re the doctors, but it’s their health, their medication, their lifestyle.”

Some studies show how healthcare consumers already demand change. “Top 10 Health Industry Issues in 2010: Squeezing the Juice Out of Healthcare” from PricewaterhouseCoopers, states, “Patients want better access to care, and jams in the delivery system are prompting them to seek quicker and more convenient treatment outside physicians’ offices and hospitals.”

Such options are not merely on the horizon—they are here, and flourishing, today. In 2009, Merchant Medicine’s “Retail Clinics in the United States” report stated, “Retail health clinics have increased nearly 20-fold since 2005 and are beginning to expand the scope of their services to include management of chronic diseases such as asthma, osteoporosis and diabetes.”

Moreover, Kathryn Gohman, chief executive officer of the Patient Advocate Group in Dallas, Texas, points out, “current media coverage of healthcare issues has resulted in opening new doors. Involvement by large companies such as Wal-Mart, which plans to have 2,000 clinics in its stores in the future, will spur others to new ideas.”

Still, no simple strategy empowers all patients. No obvious steps can magically make every treatment safe and effective for every patient in all scenarios. No technology will prevent all medication errors. Nothing will ever make the Internet or any other means of electronic communication infallible. In fact, medical challenges sweep across every aspect of human health and the role of patients in it. Still, these very challenges set the bar for future healthcare. Although the bar for improved health sits high, life and death literally depend on getting over this obstacle, and it cannot be scaled alone. As Miller says, “In the end, better treatment depends on improved participation from providers and patients.”

Only such improved participation—engaging a wider range of participants, including pharmaceutical companies and regulators—can rebuild the public’s trust in the world’s overall health enterprise.

Molly Knight Raskin contributed to this article.

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Article: The Rise of the Empowered Patient | e-Patients.net says:

September 24th, 2010 - 1:03PM

[...] a Scientific American magazine, has a long new article The Rise of the Empowered Patient. It quotes, among others, our friend Lucien Engelen (@Zorg20, which is Dutch for Health 2.0). [...]

Trisha Torrey says:

September 24th, 2010 - 1:47PM

Excellent overview of this new patient mindset, based on frustration and loss of trust.

Might I also add that no one teaches us to be empowered patients. Too often we are self-taught after being backed into corners that require we take charge of our own care.

How much better off we would all be (patients, providers, payers, industry) if the playing field was leveled by teaching all of us to partner and collaborate!

Trisha Torrey
Every Patient’s Advocate
Author of: You Bet Your Life! The 10 Mistakes Every Patient Makes (How to Fix Them to Get the Health Care You Deserve)

The Rise of the Empowered Patient (Scientific American Pathways) « e-Patient Dave says:

September 24th, 2010 - 2:09PM

[...] The Rise of the Empowered Patient (Scientific American Pathways) Pathways, a Scientific American magazine, has a long new article The Rise of the Empowered Patient. [...]

Carolyn Thomas says:

September 24th, 2010 - 5:26PM

Excellent article, Nicholas (and Molly!)

Dr. Scott Haig‘s November ’07 Time magazine essay called ‘When The Patient Is A Googler’ (a scathingly arrogant attack, by the way) describes his Googling patients as “suspicious and distrustful, their pressured sentences bursting with misused, mispronounced words and half-baked ideas.”

Just a tad oversensitive to having his ‘Doctor Knows Best’ authority undermined, perhaps?

WebMD alone gets over 40 million visits every month. Up to 80% of internet users report they have sought medical information online. And a reported two-thirds of patients apparently want their doctors to recommend reliable website resources for them. The times, they are a-changin’…

But online searches are not just for the “empowered patient” – they can also be a diagnostic tool for physicians. Australian researchers reported in the British Medical Journal on a study that chose 3-5 search terms for hard-to-diagnose illnesses, and then looked at how Google did compared with reports published in the New England Journal of Medicine. The study found that doctors who use Google to help diagnose difficult cases can find a correct diagnosis over 60% of the time.

I wish that the ER doc who sent me home in mid-heart attack with an acid reflux misdiagnosis had instead tried Googling my symptoms (crushing chest pain, nausea, sweating and pain radiating down my left arm).

I’m now fairly confident that Google would have steered him to the correct diagnosis.

Here’s what I’ve learned about heart attack misdiagnoses in women since that day in May 2008: we now know that one in 50 people will be misdiagnosed and sent home from the E.R. in mid-heart attack, UNLESS you happen to be a woman under the age of 55, in which case your odds of being sent home are SEVEN TIMES greater.

That crisis – and then being invited to later attend the annual WomenHeart Science & Leadership Symposium for Women With Heart Disease at Mayo Clinic – led me to launch HEART SISTERS, what I thought would be just a little blog about women and heart disease – our #1 killer.

More on empowered patients at “What Doctors Really Think of Medical Googlers” at:

http://www.myheartsisters.org/2009/08/19/med-google/

Empowered Patients says:

September 24th, 2010 - 9:07PM

[...] article from Pathways emphasizes some of these points, so I thought I’d share!  Here’s the link to the complete [...]

Tweets that mention Pathways » The Rise of the Empowered Patient -- Topsy.com says:

September 25th, 2010 - 4:50AM

[...] This post was mentioned on Twitter by Bora Zivkovic, Shwen Gwee, Jeff Benabio, MD, Trisha Torrey, Brian Mossop and others. Brian Mossop said: Consumers now taking control of their own treatments. http://bit.ly/aHN8Et /via @sciam pathways. (cc @SusannahFox @gfry) [...]

Quick Links | A Blog Around The Clock says:

September 25th, 2010 - 4:02PM

[...] The Rise of the Empowered Patient [...]

The Online Patient’s Bill of Rights | Stop Moles! says:

September 27th, 2010 - 5:01PM

[...] needs empowered patients. Empowered patients need protection. Following President Obama’s kick-off of the [...]

Amara Russell says:

September 29th, 2010 - 9:01AM

There has been a Pregnant Patient’s Bill of Rights for many years:
http://www.aimsusa.org/ppbr.htm
The concerted efforts of women to gain empowerment in birth have been actively resisted & opposed at every turn (with so many examples over the decades they fill books)… a recent one being the “catch-22″ standard of care revision for VBAC (vaginal birth after cesarean) created by the professional trade union ACOG and imposed on birthing mothers by it’s members. This specialty for one has a very long way to go to achieve their “culture shift”; they first have to want to…and they show no signs of anything like that collectively. The bright side is that the ‘medical standards of care’ make woman-centered midwifery care the clearly and obviously superior choice, because the many advantages of this care model are brilliantly apparent in contrast…only one of which is the consistently superior outcomes. Empowerment can be had NOW just outside the medical model in the realm of holistic care. The wisdom & knowledge by which humanity has evolved is trustworthy because it has stood the test of time…and people are returning to it in droves.

Davis Liu, MD says:

October 5th, 2010 - 1:54PM

Excellent articles that depicts the challenges for doctors and patients navigating this new world. Patients will need the tools to educate themselves which is why I blog and write because no one teaches people to be empowered patients.

Davis Liu, MD
Author of Stay Healthy, Live Longer Spend Wisely – Making Intelligent Choices In America’s Healthcare System
(available in hardcover, Kindle, and iBooks)
Blog: http://www.davisliumd.blogspot.com 
Twitter: davisliumd 

Julia Hallisy says:

October 5th, 2010 - 5:18PM

Thank you for this informative article. Our organization is responding to the needs of empowered patients through online resources, community training, books, videos and a patient survey. Please visit our website at http://www.EmpoweredPatientCoalition.org for more information.

The patient empowerment movement has made great strides and we continue to educate and assist patients who realize that they need information, support and confidence to improve their health care experiences and outcomes.

Outside the silo says:

October 18th, 2010 - 5:43AM

[...] voice of patient engagement” – which pointed me to a Scientific American article on The Rise of the Empowered Patient. It’s worth reading. “An empowered patient is someone who has figured out that healthcare [...]

Health Digital Check-Up: E-Patient Connections | Edelman Digital says:

October 20th, 2010 - 7:20PM

[...] many may see the term as fairly hum-drum by now, the participatory medicine movement is really just heating up. According to e-patient Dave, more and more patients are being included in “leaders in health” [...]

uma says:

November 15th, 2010 - 9:49AM

Gone are the days when the doctor was a God whom we could blindly believe and rely on as a patient. Googling helps me understand my own physical condition and others too; come up with questions for whom i am one of the many but for my loved ones i am the only one !So i need answers to Why me only? And here is one experience that drives my nuts. In my 24th week of pregnancy the gynaecolgist saw a problem in the sonography reports.However never told me the impact or risk . Never told me to just shut shop , relax and reduce the salt intake . Had she done that i would not feel so guilty to bring a premie lowbirth weight baby to fight for survival in the NICU. That incident has forced me to google, contact individuals with the same problem and procure maximum information.Thanks to Google and all the networking sites I am a very well read mother now!

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