This doctor is very conscious of
labeling patients. Contrary to many doctors that don't mind
stereotyping us, it is refreshing to read a doctor that is concerned.
I am surprised that different groups are so eager to put labels on
us and this label is unacceptable or should be to most people.
I am very appreciative about Dr. Wen's
discussion and her distinctions about labeling us as healthcare
consumers. We do consume healthcare, but not in the traditional
sense. As Dr. Wen explains, we should not be healthcare consumers
this way as it could be very unhealthy to postpone receiving
healthcare the way consumers do when purchasing consumer goods.
I have blogged about the types of
patients here, here, and here. I feel that we should remain
patients, but know there are different types of patients. I do feel
that as we move away from some of us older patients, many of whom are
passive patients, the term patient will gain in respectability and
the patient will gain in knowledge about health and especially the
health issues they may have.
Dr. Wen correctly states the following,
“I also worry about effects of rebranding on the
physician-patient relationship. What happens when the doctor becomes
the hired consultant of the savvy shopper patient? Perhaps the
doctor will be more responsive to consumer demands—but perhaps this
doctor will also feel more obligated to give the consumer exactly
what he wants, including unnecessary tests and harmful procedures.
And will these physicians still retain their sense of social
responsibility, when healthcare is reduced from societal obligation
to personal choice?”
Her statement, I feel, states the crux
of many of the problems we are facing now with the advertising of new
drugs. Then as patients, we are now facing stereotyping and labeling
under the “Patient Activation Measure” (PAM). This was not the
original intent, but in large part has been bastardized to what the
doctors want it to be. Originally it was as a measure to determine
how educated we were and if we would use this education to make our
health better. Now, unfortunately, many physicians use this to help
them determine how compliant we are or will be.
Dr. Wen's last paragraph states some
good points. I do not believe we need to change the meaning of
patient like she states, but to classify patients at types. We can
have the normal patient that we have now. There is the passive
patient of which there are far too many. The proactive patient is
becoming more in number, but they are still trying out their wings
and learning to apply what they are learning. Then we come to the
empowered patient that knows how to learn and apply the information
to various medical situations. The e-patient is an advanced
empowered patient and in addition to having learned about the medical
situation that he or she is involved in, knows how to apply this
knowledge across a broad spectrum.
A special status called patient
advocate applies to people that have likely received education in
advocacy and they are trained to provide guidance to the other types
of patients. Some will be very specialized in billing, others in
medical procedures affecting patients and how physicians and surgeons
avoid raising certain issues to not alarm patients and have them
consider alternatives to their condition which may be just as
effective, but less profitable for the physician or surgeon.
Dr. Wen is also another doctor that is
concerned about the consumerism already in place where many believe
more is better. She is another that believes healthcare is not a
limitless commodity. This is a good thing for many doctors to be
concerned about, but we do need to be cautious about unbridled
rationing. This is just as dangerous and will often shorten the
lifespan of many innocent people. Finding that delicate balance is not for
the faint of heart.
I had never thought about the perspective of docs caving to pressures of a patient just to stay in business. Thanks for opening me up to that.
ReplyDeleteThanks Scott. I enjoy reading good doctor blogs and I have had some correspondence with her about this topic and she has a very positive attitude on the topic of patients.
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