Tag Archives: Health care

Why would anyone think engaging patients is not good for healthcare?

Conversation between doctor and patient/consumer.

Conversation between doctor and patient/consumer. (Photo credit: Wikipedia)

Patient Recognition Month Poster

Patient Recognition Month Poster (Photo credit: Army Medicine)

Almost everyday in the media and on websites around the world someone, somewhere, comments and discusses the importance of engaging patients. As if this is something surprising and new!

What is surprising to me, is that the topic continues to be debated, and commentators continue to try to persuade non believers and key healthcare stakeholders that this has real benefit. And, it’s true, not everyone is convinced it’s a good thing.

The concept has been around for years, and there as many success stories as there are failures, but commentators seem very quick to want to throw out the concept without completely understanding that it is the ‘how’ that is most likely at fault. Clearly, not every patient wants to be engaged, but certainly many of them do. Just look at the number of folks who look at health related topics on the internet – a recent study by Pew Internet found that 80% of internet users, or about 93 million Americans have searched for health related information on line. That is a lot of interested healthcare consumers!

So it is definitely the ‘how’ that causes the problem. Each of us have a different view about how we want to be engaged, be it in healthcare or anything else. So flexibility is the key, and what I see so often is that engagement is clinical code for compliance: ‘we need to educate this patient so that they understand their condition and follow their treatment’. But, to be honest, it simply does not work like that. Clinicians still have that scientific, data driven, clinical view of the world and continue to struggle with the idea that they are working with people, most of who have a strong notion of what health means to them. And it may not agree with accepted clinical thinking. But it is their health and their body, and clinicians need to better understand that a good outcome for one patient may not be good for another in some cases.

So, as with all things in healthcare, when we are speaking about engaging patients it needs to fit the individual patient’s view of what engagement means to them. For some, light touch, for others more information and data, while others may just want to feel heard. Anyway, patient engagement is not one size fits all, and if we are to engage patients in any meaningful way we need to work with all stakeholders to change behavours and rewards, and actively encourage patients to become more involved in their health management.

If we can do this, we will have better health outcomes for patients while driving down the cost of healthcare. For pharma, it may even have the benefit of improving adherence and increasing their profitability.

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I thought healthcare was supposed to be about you and me……

Hands up if you are a clinician.

How about a medical researcher or in academia? What about if you are working in healthcare?

Why do I ask? Well I just had something of a ‘lights on’ moment. I was watching a great presentation about health literacy from a very prominent and thoughtful clinician and researcher. She had a great presentation – very thought-provoking and also insightful – a great combination.

But listening to her – and let me say that she really ‘get’s this stuff’ that’s clear. But. She get’s it as a clinician. The way she spoke, the terms she used, and the research driven, data based approach to things made it clear to me that one of the biggest issues we have is that healthcare is more about the science and the healthcare practitioners than it is about you and me.

The big debates. Key issues and questions all led by industry insiders. naturally enough taking a science based approach. Where is the expert input from you and me?

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Is this simply all about the money?

 

English: Total U.S. healthcare spending. 1960 ...

English: Total U.S. healthcare spending. 1960 to 2007. Percent of GDP (gross domestic product). Data is from OECD Health Data 2009 – Frequently Requested Data. (Photo credit: Wikipedia)

Healthcare can form a significant part of a country’s economy. In 2008, the healthcare industry consumed an average of 9.0 percent of the GDP across the most developed OECD countries. The United States (16%),  France (11.2%) and Switzerland (10.7%) were the top three spenders (Wikipedia).

In the US, that accounts for more than 2.2 trillion dollars per annum.

This is not one of those issues where clearly the more money you throw at the problem the better the outcomes will be.

Yet what does this huge amount of money the US spends each year on healthcare do for the health of the population. Because it does not deliver the best health outcomes the world has to offer (at least according to many) so what does it deliver?

One answer can be: it delivers huge profits to some of the players. With so much money at stake, in the US, companies are competing to expand their share of the pie. Many corporations return considerable profits to shareholders and Wall Street – yet those profits never seem to be enough! So when it comes time to reform, restructure, realign, reinvent healthcare, then those with vested interests can prove difficult partners. It is this profit driven approach that really contributes to making healthcare reform in the US such a difficult process.

Not that this only applies to the US. In Europe, where a single payer is the norm (government funded model), money, or today, the lack of it, drives much of the healthcare agenda. Governments are desperate to cut the cost of healthcare delivery. Almost it seems at any cost. yet the barriers to change seem to be as mountainous as those in the US.

So, we have more than 50 million people without health coverage in the US, a plethora of corporations making billions of dollars of profit year on year, the rising cost of healthcare, the rise of medications and treatments that can cost up to $400,000 pa per patient and a general debate that the system is not sustainable. In Europe, countries are restricting the type of interventions delivered, delaying new innovations, cutting salaries of healthcare professionals and outsourcing as much as possible…..

And so it goes on.

There is a real perception, both in Europe and the US, that in order to continue to provide good quality healthcare, costs must continue their trajectory skyward. That better healthcare simply is going to cost more.

I disagree!

Foto de David MacKenzie Ogilvy

Foto de David MacKenzie Ogilvy (Photo credit: Wikipedia)

The well known advertising guru from years gone by – David Ogilvy – famously said that he knew 50% of his advertising spend was wasted, but that he didn’t know which half? Seems to me, the same applies. There is so much waste, duplication of effort, competing interests etc that it is hard for some people to believe that better healthcare does not have to cost more money.

This is the challenge for us all today. What do we need to do that will enable us to continue to deliver good health outcomes, or better health outcomes, to more people, without costing more?……….and so the debate continues.