{"id":69280,"date":"2017-06-29T17:11:38","date_gmt":"2017-06-29T23:11:38","guid":{"rendered":"https:\/\/dh.durangoherald.com\/tj\/patient-care-shouldnt-be-just-a-slogan\/"},"modified":"2017-06-29T23:11:38","modified_gmt":"2017-06-29T23:11:38","slug":"patient-care-shouldnt-be-just-a-slogan","status":"publish","type":"post","link":"https:\/\/dh.durangoherald.com\/tj\/patient-care-shouldnt-be-just-a-slogan\/","title":{"rendered":"Patient care shouldn\u2019t be just a slogan"},"content":{"rendered":"
\"Trudy
Trudy Lieberman<\/span>du1-i-syn<\/span><\/figcaption><\/figure>\n

The man chose to have his chemotherapy and radiation treatments at a hospital close to his home instead of at one of the larger hospitals farther away. Not surprisingly he wanted family nearby.<\/p>\n

Nearly two months later, in mid-June, his treatments finally began.<\/p>\n

Why the delay?<\/p>\n

His daughter told me the nearby hospital \u201chad no record of two appointments they had made with my dad and rescheduled at least once.\u201d She asked me if her father was being neglected because he was on Medicare, adding, \u201cHe is so angry. We are so angry. So much for urgency and professionalism.\u201d<\/p>\n

So much for patient-centered care \u2013 that buzz phrase that\u2019s all the rage in healthcare circles. It goes by a lot of different names like patient engagement, patient activation, and shared-decision making. If care is truly patient-centered, it revolves around eight principles identified in research by the Harvard Medical School and the Picker Institute. They include respect for patient preferences, coordination of care, information and education, physical comfort, emotional support, involvement of family and friends, continuity and transition, and access to care.<\/p>\n

For the family in question, the Nebraska hospital simply didn\u2019t meet those standards.<\/p>\n

What passes for patient-centered care falls short for a lot of other people, too, like one man who spent weeks trying to get his diabetic test strips. His current supplier had lost its Medicare contract, and Medicare sent him a letter advising him of a new approved source. He called the number he was sent and ordered new strips. A week later he went to the pharmacy to pick up his supplies but was told they had no record of his order. Days passed before he got the strips.<\/p>\n

Six months later he encountered another problem \u2013 this time with his supplier of pens used to inject insulin. He ordered them and approved the charge to his credit card using a telephone automated order system. Several days later the supplier called and left a message asking him to confirm the shipment. When he called back, he learned the cost exceeded the limit for automatic approvals, and the order wouldn\u2019t be processed until he personally approved the charge. No one had told him there was a limit. So much time had passed that he had only a two-day of supply of insulin left. \u201cThe delay created a potential emergency,\u201d he said.<\/p>\n

Often patient engagement has come to mean selling things, particularly tools and devices, that purport to help patients manage their care. During the man\u2019s many calls with the supplier the company tried to sell him knee and back braces, advising that Medicare would pay if he got a doctor\u2019s prescription.<\/p>\n

Last year I was invited to attend a panel discussion about innovations in patient engagement. The room was full of young marketers eager to sell their products and share the best ways to reach patients. Since the term patient engagement is so slippery, it wasn\u2019t surprising the program began with a discussion of what it actually meant.<\/p>\n

One panelist offered this definition: \u201cIt really has to do with how can you get patients to do more or become more active in the ecosystem about their health.\u201d Another said, \u201cLet\u2019s think of patient engagement as a marketplace. How are they engaged in the marketplace?<\/p>\n

Perhaps he meant that people like the man who needed an insulin pen pronto would be \u201cengaged\u201d enough to buy a brace he did not need.<\/p>\n

Another panelist noted, \u201cPeople\u2019s engagement with health is quite low. There\u2019s a gap we\u2019re seeing between technology and tools and the patients and doctors involved in using them.\u201d A fellow panelist said patients \u201cdon\u2019t want just excellent care. They want an experience.\u201d<\/p>\n

Most experts would argue that patients too often are not getting excellent care. Postponing medical treatment because of schedulers\u2019 errors and nearly running out of insulin because a company\u2019s procedures are inefficient hardly qualify as excellent care. \u201cExperiences\u201d like those are all too common.<\/p>\n

That\u2019s not to say patients shouldn\u2019t be active in their care. Growing evidence suggests that patients who are more actively involved have better health outcomes. But that doesn\u2019t mean profit-seeking providers should be pushing unnecessary care, pills, or devices onto patients.<\/p>\n

I recently got a letter called a Care Consideration from Aetna, my supplemental insurer. It said, \u201cThis information was identified to support you in working with your doctor to improve your health.\u201d The letter was a not-so-subtle push to take a statin for heart disease. There was just one problem. At my last physical less than a year ago my cholesterol was \u201cexcellent,\u201d as it always has been. No medication required.<\/p>\n

Pushing a drug and trying to overrule my doctor does not qualify as patient engagement.<\/p>\n

What does patient engagement mean to you? Write to Trudy at trudy.lieberman@gmail.com<\/a>.<\/p>\n","protected":false},"excerpt":{"rendered":"

Liebermandu1-i-syn The man chose to have his chemotherapy and radiation treatments at a hospital close to his home instead of at one of the larger hospitals farther away. Not surprisingly he wanted family nearby. Nearly two months later, in mid-June, his treatments finally began. Why the delay? His daughter told me the nearby hospital […]<\/p>\n","protected":false},"author":1,"featured_media":69281,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[],"tags":[281,120,61,1369],"naviga_topic":[],"class_list":["post-69280","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","tag-agriculture","tag-colorado","tag-health","tag-medicare"],"acf":[],"author_name":"dh_admin","_links":{"self":[{"href":"https:\/\/dh.durangoherald.com\/tj\/wp-json\/wp\/v2\/posts\/69280","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/dh.durangoherald.com\/tj\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/dh.durangoherald.com\/tj\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/dh.durangoherald.com\/tj\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/dh.durangoherald.com\/tj\/wp-json\/wp\/v2\/comments?post=69280"}],"version-history":[{"count":0,"href":"https:\/\/dh.durangoherald.com\/tj\/wp-json\/wp\/v2\/posts\/69280\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/dh.durangoherald.com\/tj\/wp-json\/wp\/v2\/media\/69281"}],"wp:attachment":[{"href":"https:\/\/dh.durangoherald.com\/tj\/wp-json\/wp\/v2\/media?parent=69280"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/dh.durangoherald.com\/tj\/wp-json\/wp\/v2\/categories?post=69280"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/dh.durangoherald.com\/tj\/wp-json\/wp\/v2\/tags?post=69280"},{"taxonomy":"naviga_topic","embeddable":true,"href":"https:\/\/dh.durangoherald.com\/tj\/wp-json\/wp\/v2\/naviga_topic?post=69280"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}