Patient empowerment: A coming of age story

The February 2013 issue of Health Affairs explores a surprisingly underutilized concept in health care that, until recently, has essentially been ignored – patient empowerment.

For some, this term may conjure up unpleasant memories of annoying encounters in which demanding patients (and family members) tried to dictate their own hospital course. Yet others may recall how some well-informed patients have helped them significantly expedite, as well as optimize, the care they provided.

In an article titled "What the Evidence Shows about Patient Activation: Better Health Outcomes and Care Experiences; Fewer Data on Costs," the authors define patient activation as "the skills and confidence that equip patients to become actively engaged in their health care." The authors note that patients who are less "activated" are three times as likely to have their medical needs go unmet and twice as likely to delay medical care, when compared to patients who are more engaged. On the other hand, highly activated patients were found to be at least twice as likely to prepare questions for their doctors and seek out health information, including the quality of health care providers.

In another article in the same issue, "Rx for the ‘Blockbuster Drug’ of Patient Engagement," Susan Denzter noted that evidence is emerging that patients who are actively involved in their medical care have better outcomes and lower medical bills compared with those who are not.

The medical community is finally embracing this crucial issue. We have always known that well-informed patients can bolster their own health care – and make our lives much easier as well. But it seems that in our historically paternalistic health care system, doctors tightly held onto the reins and patients, patients blindly complied (or so we thought).

In 2000, I published "Your Family Medical Record: An Interactive Guide to Getting the Best Care," a book designed to address the tremendous void between how patients think and how we, their doctors, think. At that time, Americans had not yet grasped the importance of patient engagement, and my book is no longer in print. I was a doctor desperately trying to introduce the concept of patient engagement to the American public. At the time, I had high hopes of bridging important gaps by teaching patients easy-to-understand concepts about keeping and understanding their own health records and expediting their own care through applying basic "patient skills," such as how to prepare for visits in advance and how to think through their symptoms in a methodical, concise manner. Thirteen years later, I am thrilled to see others succeeding where I did not, for this concept is far too important to sweep under the carpet.

In the burgeoning age of the Affordable Care Act, physicians are challenged to seek innovative cost-effective new means by which we can optimize the medical care we provide. If we teach our patients a patient skill or two when time allows, we can play an important role in this important paradigm shift in the American health care system that over time will, undoubtedly, help lower health care costs and improve patient care.

Dr. Hester is a hospitalist with Baltimore-Washington Medical Center, Glen Burnie, Md., who has a passion for empowering patients to partner in their health care. This blog, "Teachable Moments," appears regularly in Hospitalist News.

The February 2013 issue of Health Affairs explores a surprisingly underutilized concept in health care that, until recently, has essentially been ignored – patient empowerment.

For some, this term may conjure up unpleasant memories of annoying encounters in which demanding patients (and family members) tried to dictate their own hospital course. Yet others may recall how some well-informed patients have helped them significantly expedite, as well as optimize, the care they provided.

In an article titled "What the Evidence Shows about Patient Activation: Better Health Outcomes and Care Experiences; Fewer Data on Costs," the authors define patient activation as "the skills and confidence that equip patients to become actively engaged in their health care." The authors note that patients who are less "activated" are three times as likely to have their medical needs go unmet and twice as likely to delay medical care, when compared to patients who are more engaged. On the other hand, highly activated patients were found to be at least twice as likely to prepare questions for their doctors and seek out health information, including the quality of health care providers.

In another article in the same issue, "Rx for the ‘Blockbuster Drug’ of Patient Engagement," Susan Denzter noted that evidence is emerging that patients who are actively involved in their medical care have better outcomes and lower medical bills compared with those who are not.

The medical community is finally embracing this crucial issue. We have always known that well-informed patients can bolster their own health care – and make our lives much easier as well. But it seems that in our historically paternalistic health care system, doctors tightly held onto the reins and patients, patients blindly complied (or so we thought).

In 2000, I published "Your Family Medical Record: An Interactive Guide to Getting the Best Care," a book designed to address the tremendous void between how patients think and how we, their doctors, think. At that time, Americans had not yet grasped the importance of patient engagement, and my book is no longer in print. I was a doctor desperately trying to introduce the concept of patient engagement to the American public. At the time, I had high hopes of bridging important gaps by teaching patients easy-to-understand concepts about keeping and understanding their own health records and expediting their own care through applying basic "patient skills," such as how to prepare for visits in advance and how to think through their symptoms in a methodical, concise manner. Thirteen years later, I am thrilled to see others succeeding where I did not, for this concept is far too important to sweep under the carpet.

In the burgeoning age of the Affordable Care Act, physicians are challenged to seek innovative cost-effective new means by which we can optimize the medical care we provide. If we teach our patients a patient skill or two when time allows, we can play an important role in this important paradigm shift in the American health care system that over time will, undoubtedly, help lower health care costs and improve patient care.

Dr. Hester is a hospitalist with Baltimore-Washington Medical Center, Glen Burnie, Md., who has a passion for empowering patients to partner in their health care. This blog, "Teachable Moments," appears regularly in Hospitalist News.

The February 2013 issue of Health Affairs explores a surprisingly underutilized concept in health care that, until recently, has essentially been ignored – patient empowerment.

For some, this term may conjure up unpleasant memories of annoying encounters in which demanding patients (and family members) tried to dictate their own hospital course. Yet others may recall how some well-informed patients have helped them significantly expedite, as well as optimize, the care they provided.

In an article titled "What the Evidence Shows about Patient Activation: Better Health Outcomes and Care Experiences; Fewer Data on Costs," the authors define patient activation as "the skills and confidence that equip patients to become actively engaged in their health care." The authors note that patients who are less "activated" are three times as likely to have their medical needs go unmet and twice as likely to delay medical care, when compared to patients who are more engaged. On the other hand, highly activated patients were found to be at least twice as likely to prepare questions for their doctors and seek out health information, including the quality of health care providers.

In another article in the same issue, "Rx for the ‘Blockbuster Drug’ of Patient Engagement," Susan Denzter noted that evidence is emerging that patients who are actively involved in their medical care have better outcomes and lower medical bills compared with those who are not.

The medical community is finally embracing this crucial issue. We have always known that well-informed patients can bolster their own health care – and make our lives much easier as well. But it seems that in our historically paternalistic health care system, doctors tightly held onto the reins and patients, patients blindly complied (or so we thought).

In 2000, I published "Your Family Medical Record: An Interactive Guide to Getting the Best Care," a book designed to address the tremendous void between how patients think and how we, their doctors, think. At that time, Americans had not yet grasped the importance of patient engagement, and my book is no longer in print. I was a doctor desperately trying to introduce the concept of patient engagement to the American public. At the time, I had high hopes of bridging important gaps by teaching patients easy-to-understand concepts about keeping and understanding their own health records and expediting their own care through applying basic "patient skills," such as how to prepare for visits in advance and how to think through their symptoms in a methodical, concise manner. Thirteen years later, I am thrilled to see others succeeding where I did not, for this concept is far too important to sweep under the carpet.

In the burgeoning age of the Affordable Care Act, physicians are challenged to seek innovative cost-effective new means by which we can optimize the medical care we provide. If we teach our patients a patient skill or two when time allows, we can play an important role in this important paradigm shift in the American health care system that over time will, undoubtedly, help lower health care costs and improve patient care.

Dr. Hester is a hospitalist with Baltimore-Washington Medical Center, Glen Burnie, Md., who has a passion for empowering patients to partner in their health care. This blog, "Teachable Moments," appears regularly in Hospitalist News.