The Prognosis for Participatory Care

As “The Innovator’s Partner,” we embrace new ideas and the big impact they can have in addressing disease and improving health. We are passionately enthusiastic about the role we and our clients can play in enhancing each patient’s journey, care, and outcomes.

But what do health care providers—in whose hands the fate of many of these new tools and treatments rest—think about all this innovation? Do they get as excited as we do? For some, the answer appears to be, “Not so much.”

Significant numbers of docs are in fact reluctant to embrace new diagnostic methods and tools, slow to adopt electronic health records, and remain skeptical of the value and clinical utility of personalized medicine.

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Some of their hesitancy is understandable: they want more clinical evidence than is available, they aren’t steeped in the science and didn’t learn about these alternatives in med school, they worry about liability, and/or they’re not sure that they’ll be reimbursed appropriately.

But it also seems that some healthcare providers really don’t want patients to be more involved in their care. As the tools, science and data sources have advanced, more information has become accessible to patients—creating expectations, misperceptions, and in some cases disparities between the level of information a patient brings to a discussion about their care vs. what the doc is prepared to discuss. This dynamic can create real frustration and sometimes even conflict between patients and providers.

I uncovered some signs of this rift in the commentary following a recent Wall Street Journal article about a company called Theranos, which is developing a nano-scale blood analysis solution that could radically change the typical blood-draw-and-testing protocols, and maybe save the system a lot of money.

The founder, Elizabeth Holmes—whom some say could be the next Bill Gates or Steve Jobs for the life sciences sector—describes the potential of the innovation in our usual patient-centric terms: “The reality within our health-care system today is that when someone you care about gets really sick, by the time you find that out it’s most often too late to do anything about it. It’s heartbreaking…. We’re finding cancer when you have a tumor, or heart disease by virtue of the fact that you’re having a heart attack.”

The commentary that followed—much of it from self-identified physicians—struck a much different chord. For example: My experience over 40 years of patient care is that patients are not “empowered” (whatever that might mean) by having access to their own health information, because they are not capable of interpreting that information. In reality, they either are needlessly alarmed by clinically meaningless variations from the norm, or they are tempted to think that they know more than their physicians. An hour spent reading on the internet, no matter how intelligent one might be, is no substitute for clinical experience and judgment… There is a reason why medical training takes as long as it does–it is not just book-learning…

In other words, “I’m smarter than you are, so just do as I say.”

Now, this one physician may not represent the mainstream—and may even have some valid points—but examples like this bring home the importance of acknowledging and addressing the clinicians’ perspective as one looks to advance new innovations. What seems to us like a dramatic leap forward might seem to them to be an incredibly disruptive interference—with potential to compromise both their livelihood and position as the patient’s learned intermediary.

It is inevitable that patients will continue to become increasingly involved in managing their care and will use the power of information about the latest innovations to advocate for the best possible treatment. But we can help to make that process easier by offering new ways for the patient to interact with the clinician that are more productive and less threatening. This will include opening up new channels and creating compelling, accurate and balanced content so that both the clinician and patient are better educated and informed about innovations, and have similar expectations about the appropriate role of new advancements in diagnosing, treating and managing conditions.