Pauline Chen: Getting Patients to Take Charge of Their Health

Quick note as I run to the airport –

Last May we reported on a study in process at Emory University about whether a “safety-net” (poor) population would engage with a personal health record. The preliminary results in that poster showed that what predicted patient performance was not how poor they were, nor how bad their mental health condition was, nor how bad their chronic condition was – what predicted performance was how activated the patient is – how engaged they are, as measured by the PAM Patient Activation Measure.

Today, a new piece by Pauline Chen in the New York Times “Well” blog reports a similar outcome at Fairview Health Services in the Twin Cities.

At first blush this looks to be huge news for the participatory medicine movement. Check it out.

(For more information on the PAM, see also our October post, with an in-depth presentation about the PAM from its creator, Dr. Judith Hibbard of the University of Oregon. In a comment at bottom she added a long list of publications that link activation to outcomes.)



Posted in: e-pts resources | found on the net | reforming hc




2 Responses to “Pauline Chen: Getting Patients to Take Charge of Their Health”

  1. Katherine says:

    Activated patients are motivated when shown the data and evidence to push ahead for health. Participatory medicine helps!

  2. Great post, what I found more insightful was the wide variety of perspectives of comments on the article and how wildly divided on both sides of the equation take charge not take charge…someone acknowledged a middle ground, which really the truth lies. (No one in the comments section indicated they were Drs). I culled a few here… (if too long I can cut out)

    – Do you fix your own car and do your own plumbing and electrical work?

    – I realize I seem unsympathetic but I have been living with a chronic disease for 15 years. I know it takes hard work and perseverance to manage it. It requires a conscious choice and I get so tired of people using every excuse not to do it.

    – Have a doctor who dismisses your questions or doesn’t answer them to your satisfaction? SWITCH DOCTORS. Seriously,

    – Switch doctors? You must have insurance that affords you a good choice of doctors, or live in a neighborhood that has some.

    – … the title of this article is misleading. Because what is meant by getting patients to take charge is actually engaging with patients and helping them take better care of themselves.

    – In some cases, that means additional at home visits by nurses and follow up visits with the doctor. It also might mean better explanations of what is needed and why.

    – This doesn’t even consider that a doctor or a mechanic may a.) not know what’s wrong at all, and just be guessing, or b.) be intentionally lying to you to make more money.

    – Either you’re curious and like to know about the connections between things, or you’re not. If you are, you can learn all you need to know about the body online. If you’re not, you’ll just “take the blue one each morning” and hope it works.

    – Physicians who want to increase patient involvement in their own care might do well to examine their own attitudes and actions, and the ways they subtly and not-so-subtly discourage patients from becoming educated about their health care.

    – The other way to encourage health would be to reward the 80% of people who consume only 20% of health care costs – that is, the moderately healthy.

    – His created a cascade of hate. Including … Second, many “lifestyle” recommendations are much easier for pious Puritan pontificators to preach than for sinners to follow.

    – Having just visited an uncle in … hospital… all complications related to poorly managed diabetes– I was full of initial condemnation, judgment, and even anger at him for allowing this to happen. .. all of my indignation faded. .. He described feelings of “frustration” and “depression” when not able to manage his condition… Now, I became a lot more indignant at a medical, social, economic, and political system that allows this to happen in our very advanced and wealthy country.

    – I completely sympathize with the physician who reluctantly volunteered that this guy brought this on himself.

    – Saying patients should just take control of their health ignores their life circumstances.

    – The fact is, my failure to “take charge” of my weight problem had nothing to do with a lack of will, and had everything to do with a medical establishment

    – … moved to France….It is really nice when Drs listen to their patients.

    Which seems to be like the place to go these days

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