Patients find more and more that their healthcare is being compromised by providers and insurers who are giving them the short shrift. Patient safety issues, money issues, lack of time and communication with their doctors... These days, wise patients are empowered patients, learning everything they can about the healthcare system, the obstacles to good care, and the steps they can take to get the best care possible.
If you are over the age of 45, you'll remember Dr. Marcus Welby. He was the skilled and kindly TV doctor who was able to solve most medical problems within the one hour he appeared each week on the small screen.
In those days, many of us thought our family doctors and general practitioners were just like Marcus Welby. They were mostly men, paternalistic and kindly, they seemed to know everything there was to know about taking care of us, they smiled at us when we arrived, they took their time and answered our questions, and most of us got well.
Times Have Changed
There are few Marcus Welbys practicing medicine today. The world of medicine has transitioned to a system that works hard to take control away from both patients and their doctors, giving rise to a new paradigm that requires patients to take more responsibility for their medical care than in the past.
The move toward patient empowerment in America seems to have begun with the Civil Rights movement in the 1970s. It was a slow beginning, until 1999 when the Institute of Medicine, an agency of the US government, issued a report called To Err is Human which reported the deaths of between 44,000 and 98,000 Americans each year due to medical errors. Thus the flames of patient empowerment were fueled, and the movement began to grow.
Patient Empowerment Defined
Patient empowerment has a handful of definitions. Most focus on the concept of the patient taking an active role in his own disease management, and supporting that participation by learning all he can about his disease or condition and treatment options.
Until the past few years, the thought that a patient would participate so fully was unheard of. Today, many patients realize that this level of participation is vital to maintaining health in the face of medical problems or challenges.
As an empowered patient, you'll need to:
Take responsibility. Realizing that you know your body better than anyone else, you will refer to all the resources at your disposal -- from people to the printed word -- and you will use that knowledge to help make decisions about your treatment that are your decisions to make.
Set goals. Understanding that the human body does not always react the way we expect it to; therefore, it's best to set a treatment goal and work toward that goal. In some cases a patient can have a goal to heal, another may simply want to manage a disease or condition, or another may need to learn to cope with a new medical problem.
Collaborate with others. You'll be an active participant on your own healthcare team, including providers, support personnel, payors, even other patients, knowing that the collaboration helps you in the decision-making aspects of your diagnosis and treatment processes.
Gather evidence. Including resources that range from observation, to recording symptoms and family histories, to participating in medical tests, to discussions with providers and other patients, to using the Internet and libraries for researching relevant diseases, conditions and treatments.
Be a smart healthcare consumer. Sometimes the challenges a patient faces are related more to customer service and costs of service than they are to the health aspects of care. Understanding health insurance choices or learning when to walk away from a doctor's practice when necessary, are examples of these kinds of choices.
Stay safe in the healthcare environment. We often read about major medical errors, but millions of "smaller" mistakes take place every day. Administration of the wrong drugs, acquiring infections in hospitals, even surgeries gone bad -- these are all examples of the safety problems an empowered patient should be aware of.
Understand and support the tenets of patient advocacy. In the bigger picture, you can take advantage of those who have learned about your medical problems before you, and you can help patients who come after you find better medical outcomes. Advocacy runs the gamut from government and not-for profit organizations, to individual navigators that help patients transition through the steps of their diagnosis and care.
- Adhere to decisions. Since you will have collaborated with knowledgeable members of your healthcare team to arrive at decisions, you will feel confident following along with the decisions you've made together.
The Empowerment Tipping Point
With more than 30 years of history, patient empowerment is approaching its tipping point. More and more, patients are realizing they can improve their medical outcomes by taking responsibility for their own healthcare decisions in partnership with their providers, and participating fully in the process.
Granted, there are still (too) many people who either choose not to empower themselves, or who, for some reason, cannot behave like empowered patients. Slowly, but surely, the un- or non-empowered patient is going the way of the dinosaur.