90.9 WBUR - Boston's NPR news station
Top Stories:
PLEDGE NOW
Health

This photo taken Jan. 30, 2013 shows patient Marlena Bechtel-Rysdam, right, from Elgin, Ore., going over home monitoring training materials with registered nurse Christina Leese at Oregon Health Sciences University in Portland, Ore. (Don Ryan/AP)

In a recent interview, physician and noted social activist Dr. Paul Farmer gave this advice to graduating medical professionals: their real impact will come when they work in teams. As the co-founder of Partners in Health and a champion of improving health in underserved communities, Farmer’s work is built on building partnerships and applying successes and lessons learned to new frameworks.

Farmer’s big idea message is alluring in its simplicity, which is what makes it such an important one. After all, collaboration, particularly in terms of community-based health care and in managing chronic diseases across specialties, is something we struggle with in this country. By 2025, an estimated 164 million Americans are expected to live with at least one chronic condition, so coordinated care that utilizes appropriate technology and minimizes complications and disease progression is critical.

Future physicians need to see patients as the valuable resource they are, recognize the ways we’re sharing health information, and know what that information looks like.

Earlier this year, the American Medical Association launched the $10 million “Accelerating Change in Medical Education” initiative. The premise of the initiative is to help facilitate “bold structural change” at each selected school. Ideally, the proposed innovations will support a significant redesign of undergraduate medical education to improve health outcomes and reduce cost, align education and training with the evolving nature of 21st century health care, and encourage physician satisfaction and more sustainable payment and delivery methods. Over the next five years, the AMA will give $2 million annually to support eight to 12 medical education innovations.

Substantive systemic change is hard to come by, and the AMA’s program is a good step. However, as a patient who has lived with multiple chronic illnesses for 33 years, I’d like to add another perspective on teamwork for medical schools to consider as they look to redesign medical education: the importance of collaboration within the patient-provider relationship.

Want to see improved health outcomes? Have engaged, informed patients who are true partners in their health care and medical decision-making. Future physicians need to see patients as the valuable resource they are, recognize the ways we’re sharing health information, and know what that information looks like. We don’t necessarily need our doctors and nurses to be on Twitter, for example, (though some do this exceptionally well) but we do need emerging health professionals to recognize the ways in which patients can harness technology and health information to best take control of our health.

According to the Society for Participatory Medicine, 90 percent of health care takes place outside the doctor’s office. Increasingly, these interactions take place virtually. Patients are not just Googling symptoms or printing articles; we’re sharing treatment information with each other in robust online patient communities. Many of us with chronic and rare diseases are using social media platforms and patient networks to participate in and encourage enrollment in clinical trials. Those of us with the digital literacy and resources to do so are tracking and sharing data with smartphones, and bringing this information to our physicians.

If partnership can bring together the expertise of medical professionals with the insights of patients, who know their own bodies and symptoms better than anyone else, then we will have the right framework for improved health outcomes.

The sheer availability of health information accessible to us doesn’t necessarily mean it is credible or reliable. We need practitioners who can counsel us on how to be discerning readers of what we come across, to assist us as we wade through the snake-oil cures and the potential conflicts of interest, and who can help us put newly published research into context with what it mean for us as individuals.

We hear the term transparency so often these days, and true collaboration hinges upon it. Transparency reaches across both sides of the desk, from the funding of research articles, direct-to-consumer advertising of drugs, and costs of medical procedures and interventions to patients’ disclosure of alternative treatments they may be trying or have questions about, for example.

When dealing with a serious health issue, 70 percent of adults in a Pew Research Center’s Internet and American Life Project survey consulted health professionals. When it comes to the emotional aspects of living with disease, patients increasingly turn to each other for support and advice, too. If partnership can bring together the expertise of medical professionals with the insights of patients, who know their own bodies and symptoms better than anyone else, then we will have the right framework for improved health outcomes.

Related:

The views and opinions expressed in this piece are solely those of the writer and do not in any way reflect the views of WBUR management or its employees.

Please follow our community rules when engaging in comment discussion on this site.
  • http://somebodyhealme.dianalee.net/ Diana Lee

    Great piece, Laurie!

    • Laurie Edwards

      Thanks so much!

  • Isobel Clinton

    This is important advice to physicians, perhaps especially those who teach. Even my long-term (25 years now) internist, a deeply respectful and kind person, becomes visibly annoyed when I’ve done research, or tried an alternative medical approach to the symptoms of persistent maladies or chronic disease (I have two). Sometimes he’ll denounce alternative therapies, only to suggest them himself years later. He refused to see the results of a thorough test I had done through an MD at an integrative health clinic near my home, then 3 years later wanted me to find, xerox and send him the multi-page results document. I’m sure persistent or chronic disease states are frustrating for the most empathetic and self-aware physician, and he is both. But perhaps training in dealing with that frustration, including the idea that a patient is a highly motivated, often quite up-to-date researcher in her own interests, not to mention a sensitive if not always articulate observer of her body’s internal conditions, would help doctors manage their frustration and accept the possibility of learning things from such patients.

  • Ezra

    Very interesting Laurie! Great advice for the doctors and medical educators, and for us all as patients as well. Without clear communication the docs are quite challenged in figuring out exactly what we know/think we know/want to know.

TOP