This is another instance of physicians
learning that patients are good learners and there is definitely a
change taking place in the doctor-patient relationship. I will admit
that even in my own experience, the standard was the doctor
prescribed and I followed his orders. As I have gained knowledge, I
have done some push back on this in recent years. Some of my doctors
have accepted this and are working with me, and at least one doctor
has not accepted this. As a result, I am no longer a patient in that
office.
This article in Medscape is from the
TEDMED 2013 conference and two physicians spoke about the changes
taking place. Both physicians felt that the opportunities for
patients' involvement are becoming greater with the advent of the
fast changing technology. Susan Desmond-Hellmann, MD, MPH,
chancellor at the University of California, San Francisco, “Explained
that she is part of a growing movement to empower patients through
digital health initiatives and precision medicine. The goal is to
cross-reference a patient's health data with a global "knowledge
network" to deliver more targeted care.”
Doctor Desmond-Hellmann was cautious
when she talked about, “There are situations where patient
participation is not possible or is severely limited, such as in
trauma, emergency surgery, or acute illness. Sometimes the best that
can be done is informed consent. But when it comes to prevention,
wellness, and chronic illnesses — these are perfect opportunities
for healthcare consumers to get involved." I would prefer
the change of “healthcare consumers” to the word patients.
This is something I can relate to and I
feel that doctors that understand this will do more conscientious
work knowing that patients in emergency situations cannot participate
and will be asking many questions once they are on the road to
recovery, provided they are able to communicate.
I whole heartedly agree with Dr.
Desmond-Hellmann when she states, “If healthcare records all
become electronic and the patients do not have access, that is
defeating the purpose. These are wonderful new tools, but we need to
use them to bring patients closer to their caregivers, in more of a
partnership."
The other speaker following much the
same thoughts was Dr. Roni Zeiger, founder and CEO of Smart Patients.
He believes that technology is, “Helping patients move from
being recipients of information to becoming experts — specifically,
microexperts. In many cases, we have patients who
aren't just experts in what they feel or experience, but in the
science of their disease." Read about Dr. Zeiger at this link.
I appreciate these thoughts and
especially when Dr. Zeiger says, “We have a culture that is just
ready to embrace this notion of a real peer-to-peer collaboration."
We need more doctors that embrace this philosophy of
peer-to-peer work and make use of it in clinical practice. I know in
the case of diabetes, this could be part of what stops the epidemic
of diabetes. This would also help in the education so badly needed
by people with diabetes.
Since this not a priority on the agenda
of the American Association of Diabetes Educators (AADE), and its
members, maybe it is time for endocrinologists to select patients who
are microexperts and give additional training where needed and then
work with other primary care physicians (PCPs) to have them assist
with education. This could be especially valuable on the areas of
sparse doctors and probably no CDEs.
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