Is that the sound of the engaging patient I hear?

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Patients Should Be Engaged, Collaborative and Entitled (to Two Opinions)

They say a picture is worth a thousand words.  Take the above, for instance.  Just a simple coffee mug but, by virtue of its slogan, it’s also become totemic in doing the rounds of debate on social media generating acres of prose in the process.

That’s because the text encapsulates a response to the times in which we live and the insecurities caused in the healthcare establishment by change.  Because of Google’s mission to organise and give us access to the world’s information, the masses are having, in some eyes, the temerity to actively investigate and even discuss the condition of their own bodies and minds.

The medical information genie is out of the bottle

But that’s democratisation of access to knowledge for you.  There is, of course, a massive difference between being able to access fact and opinion and being able to truly understand it, particularly if the context is such a complex system as a humans being. Nevertheless, the medical information genie is out of the bottle and it won’t be put back. Ever.

Before everyone jumps into their ethics versus entitlement trenches over this one, I think it’s time for a bit of reflection on the world for which we are inevitably heading. Or, in many cases, have arrived in already.

Search engines are not doctors

At the most basic level, Googling your condition doesn’t make you a doctor. Or any other healthcare professional, any more than owning car makes you a factory-trained expert auto technician.  But I think that misses an important point – it does make you an engaged patient interested in your own wellbeing.

It’s precisely this attitude that health services, physicians and patients need to embrace if they are to meet the challenges of the 21st century – medicine that needs to focus on prevention rather than cure and healthcare delivery systems that must achieve wholesale improvement in efficiency and effectiveness.

Changing the conversation

That is not to say that patients should be appearing at consultations brandishing their iPads and haranguing physicians along the lines of: `I’ve looked up my symptoms, I’ve decided I have condition Y, and I want you to write me a prescription for 20mg of medication Z to be taken four times a day and be quick about it!”

Clearly, acquiescing immediately to that sort of demand would transcend any duty of care on the part of the physician.  And make a mockery of the lengthy lifetime of training that all general practitioners have to gone through to remain qualified to make decisions about how to diagnose and treat illness.

But, in the brave new world, we are going to have to get used to patient/doctor conversations that might begin with: `I have symptoms A and B, and have had a look at specialist websites J and K, and given that my health record here on my smartphone shows I’ve had Q it sounds like it could be X, so I thought I should come to see you.  What do you think? `.

The sound of an engaged patient

The latter are likely to become more commonplace, or even the norm. But they should not be feared. That’s actually the sound of a grown-up talking – an engaged patient expressing their concern, explaining their thinking, identifying their source, being aware of their history, acknowledging their doctor’s expertise but trying to help them solve the diagnostic conundrum.

Now, and in the future, patients and the medical establishment must regards themselves as collaborators – with patients being partners in their own healthcare and owners and curators of their own health record

Rights and responsibilities

And so it should be. If, in order to close the gap between our expectations of healthcare providers and our ability to fund them, we are going to increasingly require patients to exercise responsibility in managing their own health.

Then we have to ensure they have a right, along with the medical profession also to express an informed opinion. After all it’s their life they are taking about.


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