Most Physicians, Nurses Say Empowered Patients Are Helpful

Marcia Frellick

August 09, 2017

Most of the more than 1000 physicians and nurses who responded to a recent Medscape poll said they see patient empowerment as helpful in their practice.

However, according to the poll, those numbers were very different between the two clinician groups. Slightly more than half of physicians (54%) said patient empowerment was helpful, while 82% of nurses answered that way.

The poll ran before and during discussion of patient empowerment at a Medicine3.0: Patient-Generated Data event, held July 20 in San Diego. There, panelists talked about how the growing volume and complexity of health data generated by patients affect the doctor-patient relationship.

And now the numbers are in to help inform the debate.

One Fifth of Physicians Say Empowerment Is Annoying

Among physicians responding to the poll, 21% agreed that they would characterize patient empowerment as annoying, four times the percentage of nurses (5%) who answered that way.

Similarly, more physicians answered that patients' research made care more difficult (39%) than said that it made care less difficult (24%).

Nurses were a bit less clear on that question: 24% answered that it made care less difficult; 20% said more; and 47% said neither less nor more. Nine percent were unsure.

Still, the poll numbers indicate that the discussions are not hurting the clinician-patient bond. The survey found that half of physicians and 60% of nurses said it was beneficial to the relationship. Only 17% of physicians and 5% of nurses said such research was detrimental.

Different Definitions of Empowerment

Both physicians (62%) and nurses (63%) agreed that patients have different ideas about empowerment than clinicians do.

When asked to choose the answer that best represents how they define patient empowerment, both physicians and nurses put these choices in their top two:

  • "Patient asks about pros and cons of treatment options and drug side effects" (69% of physicians and 89% of nurses selected that option), and

  • "Patient takes an active role in deciding which treatment or drug or therapy is most useful for them" (70% of physicians and 79% of nurses selected that option).

The third-most selected definition of patient empowerment was, "Patient researches symptoms and treatments and brings information and questions to discuss with their physician." Only 54% of physicians and 68% of nurses included that in their definition of patient empowerment.

Patient Research Adds Time

Both groups agreed that when patients bring in their own research to an office visit, it adds time. Most physicians (92%) said it sometimes, frequently, or always adds time beyond the allotted minutes, and 95% of nurses agreed.

There was little consensus, though, over whether patients who research get better outcomes, as shown in the figure below.

 

An emergency medicine physician who commented on the poll said, "Lay persons rarely use their research to create a differential diagnosis but rather to support their preconceived ideas."

A registered nurse who commented said even bad online information brought in by patients can open a door for discussion: "As a diabetes educator, there is a deluge of online hocus pocus, from wearing a plastic wrap body suit to drinking vinegar for weight loss. If you use the Dr Google 'misinformation,' it can be a jumping-off point for a discussion of appropriate treatment, especially when it comes to diet and exercise."

What Percentage of Patients Are Empowered?

Then clinicians were asked, "By your own definition, what percentage of your patients are 'empowered?' " On this question, answers between physicians and nurses were very similar: A majority of both physicians and nurses said they would describe less than a quarter of their patients as "empowered." Here's a breakdown of how they answered:

 

Not all patients should be empowered, according to the clinicians. More than half of physicians (53%) said at least half of their patients should not be empowered, and the numbers show 46% of nurses agreed.

But one former nurse commented that now, as a patient, she sees the need to advocate for patients' care. She said she was able to catch an error by a provider that led to her transient kidney damage.

"In this era of doing more with less I feel totally justified in being sometimes a pain in the ass, because it is my ass that is on the line," she wrote.

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