Patient-Powered Care Drives New Relationship With Physicians

Lara C. Pullen, PhD

March 23, 2015

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greatly concerned that a substantial proportion of health information on the Internet might be inaccurate, erroneous, outdated, misleading, or fraudulent, and thereby pose a threat to patients and public health," wrote Robert M. Wah, MD, president, American Medical Association, in a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. Full text

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