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Patient Engagement as Holy Grail of Health Care
This is the first article I've read that makes a connection between a patient being distrustful of medical professionals and that patient being more healthy. I see a lot of myself and all of you in this distrustful patient archetype. Long live pain in the a*s patients -- literally:
For health care professionals, patient engagement is the holy grail of health care. It is the key to patient adherence – a prerequisite to achieving better outcomes, fewer ER visits and hospitalizations and more satisfied patients. It is easy to recognize an engaged patient – they do what their health care providers recommends …what their health care team knows what is right for them.
But doesn’t engagement depend upon your perspective?
In a earlier life I spent a lot of time looking at health behavior. Among the many things I learned were the following:
• We all define health within the context of our own lives and in our own way
• We all are satisfied with different levels of healthAdmittedly there are patterns of health behavior or archetypes which can be used to segment health populations. One such archetype is characterized as 1) placing a high priority on achieving a high level of personal health, 2) being very proactive in terms of achieving and maintaining their above average health, and 3) having a moderate to high distrust of the medical professionals.
Not surprisingly, people who shared this pattern of health-related thinking demonstrated lower levels of physician visits, fewer hospital and ER visits, lower health care costs. They were also the healthiest when compared to all other patterns of health thinking and behavior. Because of their trust issues with their providers, these patients were “mavericks” doing their own thing when it came to staying healthy. In other words they were not very compliant and would be considered unengaged from the perspective of health care professionals as defined above.
People can be engaged in their own health and never see a doctor, visit a hospital, or take a prescription medication.
If you were to tell these independently healthy folks that they were “not engaged” in their own health they would likely scoff and say “what do you expect … the health care industry doesn’t take the time to understand the patient’s perspective.” In truth, aren’t people like this doing a better job than the health industry when it comes to “engagement” and staying healthy?
The point is that we as health care professionals need to start looking at things like the definition of health, health goals, compliance, and outcomes from the patient’s perspective. We need to incorporate the patient’s perspective into outcome and satisfaction measures. Only then do we have the right to “judge” whether a person (aka patient) is engaged, activated, or empowered. Once the health industry gets past this paternalistic, “we know better than you do” attitude then we can expect to see real change in health behavior and outcomes.
(from www.KevinMd.com)
Views: 577
Replies to This Discussion
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Permalink Reply by Mary Z on
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Patient engagement is probably the holy grail of patient health-our engagement in our own welfare, not necessarily engagement with the medical community.
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Permalink Reply by Terry Vella on
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Good post Mike, I thought there would have been more responses by now, maybe it was due to the weekend. I have sort of had this discussion with Mary in the past and agree with her thoughts entirely. You have to listen to what your body and brain are telling you no matter what the medical professionals say as they can get it wrong. I won't go on because I could fill a couple of hours of your time with my experiences over the last couple of years with the medical profession, until I found my sleep doctor who diagnosed me as soon as he saw me with servere sleep apnea prior to any sleep study being conducted. I owe my life to him.
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This site is a testimony to struggle patient's face to comply with the industry Gold Standard of care for Sleep Apnea. The success of many frustrated Apnea patients comes through their own efforts to find answers or pushing their physician to. High deductible insurance, or worse, no insurance situations will force a culture shift for many to either engage in being proactively healthy, or do nothing at all and accept the results. The culture will be less driven by comply or don't comply and move to invest or don't invest. Invest the time to educate ourselves. Invest in good diet, exercise and rest. Many employers are already recognizing the value of the education piece with employee wellness programs. Because it is ultimately much less expensive to train up people to better habits than to replace them. Successful physician's in this new healthcare culture will be those who get their patients to engage in healthier lifestyles before they need expensive medications.... quality sleep is one of the keys.
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Permalink Reply by Banyon on
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By the same token people should be distrustful of government and elected officials. The last eleven years have been a terrible downtrend for individual freedom in the U.S. An asssertive distrust of your government, elected officials, appointed officials, and the bureaucrats they hire can reverse this trend.
Think about the FDA and all the state licensing laws. They are harmful to your ability to be healthy and treat your health problems.
Time to get rid of the laws requiring prescriptions for CPAP and requiring that manufacturers can only sell them through licensed DMEs.
Think about it.
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Permalink Reply by Mike on
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amen to that. i've given it a lot of thought -- i.e., getting rid of prescription requirement laws for CPAP -- and believe the requirement is akin to a noose around the neck of the CPAP patient. i say cut us free.
Banyon said:By the same token people should be distrustful of government and elected officials. The last eleven years have been a terrible downtrend for individual freedom in the U.S. An asssertive distrust of your government, elected officials, appointed officials, and the bureaucrats they hire can reverse this trend.
Think about the FDA and all the state licensing laws. They are harmful to your ability to be healthy and treat your health problems.
Time to get rid of the laws requiring prescriptions for CPAP and requiring that manufacturers can only sell them through licensed DMEs.
Think about it.
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Very well written Mike. So true, I believe many people have become proactive in their healthcare. It definitely shows they really do care. I could easily blame some of my health problems on my providers, but I choose to be actively involved in my health.
I was given information by a staff person at my DME, but I really learned nothing until I'd actually started using my CPAP and found this site. I have relied little on them since that day other than to supply my disposable products. I certainly will be much better versed when I decide on a new machine itself. They are so over used by their oxygen clients that they don't have time or resources to help sleep apnea clients. I will continue to be proactive in my own healthcare as well as my husbands'. I could really go on about how he could have fallen through the healthcare cracks many years ago if I hadn't been with him at every visit.
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Nice stuff mike...goes back to my previous rants about the impersonal nature of medicine. you need to be a sqeeky wheel....you need to advocate for yourself. unfortunately the state of medicine is sickness driven not wellness and the insurance companies play it as numbers game. they can count on people just giving up. that is why they allow people to fail cpap and call the patients failures not the delivery system, it is also why they overlook alternatives such as oral appliance therapy. in the meantime do all you can to improve your health. i see a trend of us being on our own and frankly don't want the govt. to get involved. look at amtrak and the postal service. keep fighting the good fight and know that i will respond to any queries on my website, timmickiewicz@gmail.com . btw my virtual office is coming along so hopefully this will aloow me to be more proactive , best tm
Louise said:Very well written Mike. So true, I believe many people have become proactive in their healthcare. It definitely shows they really do care. I could easily blame some of my health problems on my providers, but I choose to be actively involved in my health.
I was given information by a staff person at my DME, but I really learned nothing until I'd actually started using my CPAP and found this site. I have relied little on them since that day other than to supply my disposable products. I certainly will be much better versed when I decide on a new machine itself. They are so over used by their oxygen clients that they don't have time or resources to help sleep apnea clients. I will continue to be proactive in my own healthcare as well as my husbands'. I could really go on about how he could have fallen through the healthcare cracks many years ago if I hadn't been with him at every visit.
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I agree, Mike! Iatrogenic causation is often ignored or neglected as a significant cause of illness and expense in this country. Too many doctors want to quickly hand out a prescription without even listening to a patient. I have been a "difficult" patient for many years now and I know that it has saved my life and health more than a time or two.
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Permalink Reply by RockRpsgt on
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I don't believe that a pro-active trend is going on. I ask the same two questions of everyone I see. "What do you know about sleep?", And "Did anyone explain the process to you?". The resopnses overwhelmingly are "Nothin", and "Not a thing".
I think quite a few members of these groups see the minority of the trends because they choose to be pro-active and surround themselves like wise. As a medical worker the majority don't ever become pro-active. It's unfortunate as I am very agressive in taking a pro-active stand with your health.
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The article did not say there was a trend to be proactive. It just made the distinctions and described the different outcomes.
RockRpsgt said:I don't believe that a pro-active trend is going on. I ask the same two questions of everyone I see. "What do you know about sleep?", And "Did anyone explain the process to you?". The resopnses overwhelmingly are "Nothin", and "Not a thing".
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