David B. Nash, MD, MBA

Kevin Bowman, MD

Name not available

Activating Patient Involvement

Jefferson Digital Commons

Health Policy Newsletter Editorial  1Activating Patient Involvement  “When patients and their families are educated and understand why and how they need to actively participate in their care, and when they feel empowered to do so, their involvement can help to prevent medical errors and enhance safety.”1  This is the central theme of two important new books, Patients as Partners: How to Involve Patients and Families in Their Own Care, by Meghan McGreevey, and You: The Smart Patient, An Insider's Handbook for Getting the Best Treatment, by Michael F. Roizen, MD and Mehmet C. Oz, MD.  Both books are quick to point out that countless medical errors occur and that a great majority of them are preventable.  Roizen and Mehmet reveal that “you have a 1 in 25 chance of developing a serious unexpected complication (such as a fatal infection) when you check into the hospital…[and] your odds of being affected by that potentially deadly, unforeseen complication might be as high as 2 in 5.”2  McGreevey asserts that “more than two in five, or 42%, of adults’ lives have been touched by a medical error in some way.”1  Both also go on to report that about 70%-75% of these complications or medical errors are completely preventable. These books are unique and important because in addition to exposing many of the frailties that exist in the health care system, they take the next crucial step towards preventing these errors by providing people the knowledge they need to actively participate in their own care.  Patients as Partners is essentially a “how to” book for physicians to get their patients more involved in their own care.  The book is written in the typical Joint Commission Resources (JCR) manuscript style, and is worth reading because it provides many relevant and provocative examples that illustrate its main point—why it’s so crucial to engage patients and how that goal can be achieved.  The book covers everything from defining a culture of safety and explaining its importance; to learning how to communicate with patients, including specific techniques clinicians can use in their daily practice (e.g., putting patients at ease, initiating conversations, communicating with patients and their patient advocates, and gauging patient understanding); to current efforts aimed at getting patients more involved (e.g., the Speak Up campaign).       The strength of this book rests with the many examples it provides.  It offers several informative case studies, such as the accidental death of a Boston Globe reporter at the Dana-Farber Cancer Institute and how Health Policy Newsletter Editorial  2this incident showed that “active patient involvement improves the quality of care, enhances patient self-esteem, increases patient safety, and reduces the potential for medical errors.”1  The book also contains patient perspectives, like the story of how Roxanne Goeltz and her struggle to be an active participant in her own cancer treatment underlies the importance of effective communication skills.  As the situation revealed, “when a patient feels mistrustful and afraid of medical institutions and physicians, yet wants to participate fully in his or her health care, not being able to do so may be frustrating, demoralizing, and anxiety provoking.”1  The book also offers many genuinely useful tips, such as specific steps one can take to be an effective patient advocate,  specific strategies for effectively communicating with patients, and methods of teaching patients to get involved (e.g., tell patients that it is okay to ask whether caregivers/healthcare providers have washed their hands).  And finally, the book provides helpful references to web sites of organizations that provide valuable information about patient safety and patient-centered care.  Every provider should read this book; the examples are simply too good and too poignant to pass up.  And considering that the book is also such a quick read, we think many patients would benefit from reading this book.  The only real shortcoming is that some patients might not easily see its relevance as it focuses more on ways providers can engage patients and not on specific things patients can do to help themselves.  That job is accomplished by You: The Smart Patient.  You: The Smart Patient is similar to Patients as Partners in that it highlights many of health care’s problems, and it strives to get patients more involved.  This book, however, is geared more towards patients, not clinicians.  It is also a worthwhile read because it offers patients concrete examples and guidance for taking control of their own care and navigating the often complex health care system.  It does so while using humor and entertaining illustrations.  Specific topics include choosing the right doctor; choosing the right hospital; choosing the right insurance company; understanding prescription drugs, dealing with clinicians; and understanding treatment options and alternative medicines and pain management.  The strength of this book rests with its easy readability and comprehensiveness.  The book starts off with a simple quiz “to help you gauge how much you really know about taking control of your health care.”  It Health Policy Newsletter Editorial  3includes questions like “what’s the most important thing to bring with you to the doctor’s office,” “when is the best time to schedule a doctor appointment,” “how often does getting a second opinion change treatment substantially,” and “what is the biggest advantage most HMO insurance plans have over current indemnity health-insurance plans.”  The book then goes on to systematically tackle many of these questions.  The book offers a handy glossary of medical jargon, which is translated into layman’s terms, and sample forms including health journals, living wills, power of attorney, and “do not resuscitate” orders.  Overall, this book is an excellent “how to” guide for patients who “in clear, easy steps [want] to take control of their own health care and deal with all matters that may come up when facing a medical [problem].”  To be frank, every person should read this book, providers and patients alike, as we all will be patients one day.         Regardless of whether you’re a patient or a provider, both books are a great read.  They probably won’t change your core beliefs about the health care system.  What they will do, and what makes them so novel, is that they provide numerous ways to effectively get patients more involved in their own care.  In our view, this level of patient activation is what real patient centered care is all about.  As usual, you can reach me at David.Nash@jefferson.edu.  Kevin Bowman, MD Jefferson Medical College, 2006 David B. Nash, MD, MBA Editor    REFERENCES  1.  McGreevey M.  Patients as Partners: How to Involve Patients and Families in Their Own Care.  Oakbrook Terrace, Illinois: Joint Commission on Accreditation of Healthcare Organizations, 2006.  2.  Roizen MF, Oz MC.  You: The Smart Patient - An Insider's Handbook for Getting the Best Treatment.  New York:  Free Press, 2006. 

http://jdc.jefferson.edu/cgi/viewcontent.cgi?article=1531&context=hpn

Activating Patient Involvement

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