In one sense, the movement for Patient Engagement has been tremendously successful. Key elements like shared decision making, co-production of care, and patient data portals are almost ubiquitous. Clinicians increasingly seem to value patient engagement, healthcare executives are realizing its importance, and quite a bit of money is being spent on technology to support it. The movement for Person- and Family-Centered Care, a close cousin of the E-Patient movement, is a bandwagon with countless riders. These movements are even gaining various forms of legislative support.
In another sense, these movements are struggling. At their core is a vision for a collaborative partnership between the healthcare professional and their patient. In this vision each brings to bear distinct assets to the task of improving the latter’s health, and together they produce better, more reliable outcomes than are realized in the classic professional model where the patient’s role is deferential execution of orders. In my experience over the past four years managing the care of a medically complex child, I’ve collaborated with hundreds of professionals in multiple centers and found that the classic professional model is still alive and well under a fresh coat of patient-centered paint.
My sense is that most of the energy going into these movements is producing ornamental changes and disseminating awareness that at the end of the day leaves virtually unscathed the most important target: the doctor-patient interaction. The preexisting mindsets and subconscious habits of both professionals and laypeople are proving far more powerful than the rationale and principles of collaborative care, despite the best intentions of all involved.
My assertion, based on my own professional background and the similar patterns I’ve found in healthcare, is that new processes are needed to move beyond teaching awareness of principles and rationale and actually grow the capability of individual professionals and patients to collaborate.
The vision of collaborative care is actually in conflict with the habits and mindsets currently found in our professional and patient populations, and we have to face a crucial task of skill development and habit formation that will require new campaigns and breakthroughs.
In this newsletter I offer an article expanding on these thoughts and proposing a path forward. I have also collected a handful of pieces to reinforce or illustrate what I feel are important points. I would welcome any thoughts or feedback, and hope you find this month’s newsletter interesting. Thank you for reading.
Continue reading Tyson Ortiz’s featured article: Learning by Doing: A Direction for Improving Doctor-Patient Collaboration
