How to Make Patients Healthcare Partners

November 23, 2011

We left off last week with a patient who was in distress, in denial, unsure of cost, unsure of value and unsure of the conflicting information they have received. This is clearly not the partner we need making important and sometimes life altering/threatening decisions as to therapeutic or diagnostic alternatives.

Last week I began the discussion of why patients aren’t better partners in making decisions regarding their healthcare. This week I want to follow up with a discussion on how to help patients make their role as partners more effective.

We left off last week with a patient who was in distress, in denial, unsure of cost, unsure of value and unsure of the conflicting information they have received. This is clearly not the partner we need making important and sometimes life altering/threatening decisions as to therapeutic or diagnostic alternatives.

The right question

So, if we want patients involved in their healthcare decisions, what should that mean? As physicians and providers we need to make sure our patients do not just question whether a treatment, laboratory test, or X-ray are necessary, we need to make sure they are asking the right question.

The right question is not, “Do I need this?” but, “What is the value of the treatment, laboratory test or X-ray in my treatment?” This is a more difficult question for us to answer as physicians and providers, but it is the right question. It requires that we give the patient an education regarding their illness, the treatment and diagnostic options, the expected outcomes and the possibility of complications and finally, what the overall prognosis for their illness really is. During this process we need to help the patient come to terms with their illness and help them work through the issues they will face now and in the future.

Hard discussions

These discussions are hard for all concerned and are not for the physician or provider that is faint of heart. Once the discussion is opened, the patient and the family in many cases, will no longer be satisfied with a pat on the hand and a “there, there” from the person they are looking to for answers. No, once the patient and their family are on the inside, their search for answers and the right thing to do will increase. At that point, they do become true partners in their care and then the healthcare team can make true progress in choosing the right options at the right time for the right reasons.

A question of value

It is in answering the question of value that we really become partners. The value of life, the value of the options available and, in the end, the very value of our care is what we really need to question and discuss to change our patients into partners. To paraphrase, it’s not a destination, but a journey.