Wednesday, April 25, 2012

Patient Engagement: Double-Edged Sword?

Patient Engagement. I like these words, actually. I think that patient engagement is a great idea… a challenge, but a good idea nonetheless. So, I generally start all of my posts with an simply worded explanation of the concept for those who are not familiar and this will be no different.

The idea behind patient engagement is simple. Many assume that if healthcare providers can get patients more involved, more interested in their own healthcare, it will result in better outcomes, fewer re-admissions, and just better overall health for their patients. So what does it mean to get patients interested and involved? That is a tough one… Why? Well, there is a double-edged sword hidden in the answer.

When healthcare providers refer to patient engagement, they are usually talking about patient’s following the doctor’s instructions. For example, ‘engagement’ in the usual context may refer to a patient taking medication as prescribed. But, that hardly meets the real definition of engagement. To be engaged, really engaged, a patient needs to be educated about the course of their disease/condition, self-care, and treatment options. Further, the patient must have full access to their medical records.

Perhaps, now you can see the other edge of the sword emerging. Patients who are really engaged may in fact choose to pursue treatment options (or wellness options) that go against traditionally accepted medical advice. Patients who are truly engaged, may challenge their doctor’s recommendations or ask a lot of questions. For example, I have a friend who chose to treat her child’s scoliosis with chiropractic rather than seeing the orthopedist recommended by the pediatrician. Was it the right choice? I don’t know – I am not a doctor.

The point is clear, though. Patient engagement offers patients an opportunity to take control of their healthcare. Still, maybe we should consider other possibilities. I hate to say this, but we all know it is true.  Sometimes information in the wrong hands can be dangerous. Further, the internet is full of erroneous information. How will people who are not medically trained sort through it all? Could patient engagement result in worse outcomes, more re-admissions, and less healthy patients?

Believe me, I am not implying that I disagree with patient engagement in healthcare. I am simply saying we need to be very careful of its applications. If patients are to be more engaged, healthcare providers need to see that engagement will result in much more than patients simply following instructions. Therefore, the only solution is for providers to guide patients to legitimate information, encourage open dialogue, and be open minded (not condescending) when it comes to discussing alternative therapies. 


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