{"id":2478,"date":"2012-06-06T13:05:16","date_gmt":"2012-06-06T17:05:16","guid":{"rendered":"http:\/\/pmedicine.org\/journal\/?p=2478"},"modified":"2023-02-20T11:03:25","modified_gmt":"2023-02-20T16:03:25","slug":"the-power-of-facilitated-followup","status":"publish","type":"post","link":"https:\/\/participatorymedicine.org\/journal\/opinion\/editorials\/2012\/06\/06\/the-power-of-facilitated-followup\/","title":{"rendered":"The Power of Facilitated Followup"},"content":{"rendered":"

Abstract<\/h3>\n

Keywords<\/em><\/strong>: Physician-patient communication, patient-physician communication, patient engagement, participatory medicine, health data.
\nCitation<\/em><\/strong>: Graedon J. The power of facilitated followup. J Participat Med. 2012 Jun 6; 4:e12.
\nPublished<\/em><\/strong>: June 6, 2012.
\nCompeting Interests<\/em><\/strong>: The author has declared that no competing interests exist.
\n <\/p>\n

More than 20 years ago, I got into a heated argument with Tom Ferguson, MD, the guru of the medical self-care movement, the founder of e-Patients.net, and the creative inspiration behind the Society for Participatory Medicine. Tom imagined a day when doctors would interact with patients online, even prescribing medications, while people would buy their prescriptions from web-based pharmacies. Tom envisioned a time when many more prescription drugs would become available over the counter.<\/p>\n

Such concepts seemed anathema to me. Where was the doctor-patient interaction? What about drug side effects? How could this concept ever be implemented in a way that would protect patients from drug disasters? I was convinced that the risks were just too great and the benefits way too small to permit either e-prescribing or significant over-the-counter switching.<\/p>\n

Two decades later, Tom\u2019s vision is poised to come true. The Commissioner of the FDA, Margaret Hamburg, MD, has floated the idea that patients might better manage chronic conditions like diabetes, hypertension, and heart disease if they had access to powerful prescription medicines. Dr. Hamburg has suggested switching some cholesterol-lowering medications, blood pressure pills, and diabetes drugs to over-the-counter status. E-visits are now common and millions of people buy their prescriptions from online pharmacies like DrugStore.com. <\/p>\n

Rather than oppose the dawn of this new age, I am ready to embrace it. Tom persuaded me that his vision would be in the best interest of patients. Not only that, it could be efficient. It might even save a lot of money for a badly broken health care system. What\u2019s more, Tom\u2019s vision of the future of health care applies to much more than medications. It could have a positive impact on every aspect of health care as we know it today.<\/p>\n

What was Tom\u2019s vision? Great followup!<\/em> Tom asked me a critical question all those years ago. \u201cHow well is the current system working?\u201d I had to admit that it was abysmal. Even then doctors, nurses, and pharmacists had little time to discuss treatment plans or drug benefits and risks. Tom convinced me that the rubber meets the road after<\/em> someone leaves the doctor\u2019s office and starts taking the medicine or implementing a care plan. Tom forced me to think about the key questions people needed to ask shortly after they got home:<\/p>\n