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Patient Powered Care

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    #@&5&49 Well-known member

    Mar 4, 2012
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    Patient-Powered Care: Driving A New Relationship With Physicians?
    News Author: Lara C. Pullen, PhD


    Few among us would argue that the paradigm of healthcare, and particularly how the lay public accesses health information, has undergone major changes during the past decade. Information has been made widely available via new electronic resources, with the potential to empower billions of patients.

    However, one of the limiting steps toward increasing the autonomy and decision-making power of patients is the quality of the information culled from resources such as the Internet. Scullard and colleagues addressed the issue of the reliability of pediatric health information available on the Internet in a study published in the August 2010 issue of the Archives of Disease in Childhood.

    The researchers evaluated the first 100 search engine results for 5 different questions regarding the health of children and adolescents. They found that 39% of websites in the search gave correct information, 11% provided incorrect information, and nearly half did not address the health question.

    Accuracy was lowest regarding vaccines' relationship to incident autism (51%) and highest (100%) for information on breastfeeding during mastitis and infant positioning during sleep. The authors found that government websites were 100% accurate, but no sponsored site provided accurate medical data.

    This research illustrates the potential of the Internet to inform and empower patients, as well as how far we have to go. A new analysis by a patient named Dave deBronkart published in the British Medical Journal suggests that the era of people-powered care is not something to aspire to; in fact, it's already here.



    Patient-powered care is a progressive social movement that focuses on patients improving medical care, sharing responsibility for health outcomes, and thinking for themselves, according to an article by Dave deBronkart, from the Society for Participatory Medicine in Nashua, New Hampshire.

    deBronkart, who was recently named a visiting professor in internal medicine at the Mayo Clinic in Rochester, Minnesota, on the basis of his patient advocacy and efforts to change the way patients fit into their own medical care, describes a growing movement that asserts that clinicians and patients must collaborate.

    "Useful knowledge plus clinical experience plus what the patient wants leads to best care," he explains. He emphasizes that the movement is not antiphysician but, rather, focuses on partnerships between physicians and patients.

    "I think that's a pretty good draft of a model," Richard J. Baron, MD, president and chief executive officer of the American Board of Internal Medicine in Philadelphia, Pennsylvania, told Medscape Medical News. He described deBronkart as a very important patient voice who articulates to physicians the power of patient engagement. "I think the impact of his article is to say that we need to be working in a shared space with patients," added Dr Baron.

    deBronkart begins his article, published online February 10 in the BMJ, by acknowledging that the practice of medicine is, at its essence, intellectually demanding. The practice has, perhaps, been made even more demanding by the arrival of "e-patients," who are empowered, engaged, equipped, and enabled.

    The American Medical Association, the Institute of Medicine, the Mayo Clinic, and the World Health Organization have all weighed in on the role of educated patients as partners in medicine. Both the American Medical Association and the Belgian government are on record as discouraging patients from Googling their health problems and joining chat rooms to discuss solutions.

    "While immediate access to online information has been of great benefit to patients and health care professionals, the American Medical Association is greatly concerned that a substantial proportion of health information on the Internet might be inaccurate, erroneous, outdated, misleading, or fraudulent, and thereby pose a threat to patients and public health," wrote Robert M. Wah, MD, president, American Medical Association, in a statement to Medscape Medical News.

    Other medical organizations, however, appear to believe that the value of the Internet to the patient outweighs the harm.

    Dr Baron agrees that the Internet is a useful tool for educating and empowering patients. He views the patient-powered movement as part of a larger, global trend that includes scepticism of authority. This has largely stemmed from the ability of the Internet and social media to level the differences in knowledge access that had previously existed between patients and physicians.

    "I think that patients want to be partners in their care today," he explained. "Many patients now will have done some research and will have networked with other people in similar situations," he added.

    The combination of patient desire and patient research should facilitate a partnership between physicians and patients. Dr Baron sees this as a positive change for both patients and physicians.

    "I think it is more fun to be a doctor when you are working with engaged patients because you are more in touch with the human side of medicine.... [Physicians can experience] more joy out of the human connection," he emphasized.

    deBronkart, Dr Baron, and Dr Wah have disclosed no relevant financial relationships.

    BMJ. Published online February 10, 2015.


    The author is a patient with a history of cancer; he also is the first patient to serve as a visiting professor in internal medicine at the Mayo Clinic.
    His overall message is that patients and physicians must collaborate.

    The physician brings clinical knowledge and experience, but those qualities are augmented by a patient who brings his or her life experience, particular skills, resiliency, unique beliefs regarding health and well-being, and a deep personal stake in the outcome of the case.

    The author defines "e-patients" by the following qualities: empowered, engaged, equipped, and enabled. Leading advocates for this movement have formed their own society, the Society for Participatory Medicine, and are having a broad effect among patients and professionals alike.

    There should be further research into best practices in patient engagement. Knowledge is much more attainable now for all, and patients can connect with peers in addition to the healthcare system to receive information and comfort. But how to employ these connections to maximize outcomes constitutes a whole new field of medical research.

    At the same time, medical dogma is constantly being revised and improved. The author advocates that patients themselves can help physicians by understanding the latest data regarding their conditions and treatment.

    The author also labels patients "an oppressed class," but he does not describe precisely how they are oppressed, or by whom. Simultaneously, he notes that even the most emancipated patient should respect the clinical experience of a physician.

    A good model of care would include not just medical knowledge and clinical experience but also patient choice.


    A previous study found correct answers to pediatric health questions in a minority of sites. Government websites consistently provided accurate information, whereas sponsored websites did not.

    The current analysis calls for a transformation of healthcare into one in which patients are regarded as being on at least an equal footing with healthcare providers, with each party bringing unique skills and knowledge to maximize patient well-being. There needs to be more research into best practices in patient-powered care.


    So, after reading the article, Im curious about peoples thoughts and opinions on this topic. Please share.
    PintoBean likes this.

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