Take 'Healthcare 101' and See the Doctor

Cheryl Clark, for HealthLeaders Media , September 27, 2012

What the course should teach

There's probably some truth to that argument. But I argue back that we should try to fix this.

In my hypothetical Healthcare 101 curriculum, there'd be sections on licensing and certification credentials so patients would understand competency differences—say, between a nurse practitioner and a registered nurse.

There'd be a brief section on how the Patient Protection and Affordable Care Act is changing payment incentives, which is changing the way hospitals and doctors provide care—imposing penalties for readmissions, infections, hospital-acquired infections, and other conditions, and establishing core measures of care. I'd spend time on rating systems, like those offered by Consumer Reports and Leapfrog Group, so consumers are more likely to shop for quality.

They'd see why these things are important and how many dollars are associated with performance. And that health consumers play a critical role in that process.

And they'd learn that doctors shouldn't provide healthcare through instinct alone because there is science and rules to what constitutes proper care. They'd hear why an antibiotic will do nothing to cure a viral cold, and the difference between clinical trial evidence and what a relative swore about herbal therapy or high colonics. (It continues to amaze me that even some of my most well-educated friends don't get this at all.)

By the course's close, patients would better appreciate how healthcare is a fast-paced business where the services that a doctor wants them to have—say a test or a drug or a procedure—may not be what they need or want, especially if they knew the alternatives and potential downsides. The phrase "informed shared medical decision" would become part of their lexicon.

They also might come to appreciate how smoking or being overweight increases their chance of requiring expensive, acute care and an early grave. It's far less "que sera, sera" and much more about choice.

What do you think? The accredited patient. It has a nice ring to it. Class dismissed.

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4 comments on "Take 'Healthcare 101' and See the Doctor"

Eve Harris (10/1/2012 at 8:28 PM)
This strange (facetious?) suggestion is NOT patient-centered and does not actually empower patients or do much of anything to fix the broken healthcare delivery system.

Bart Windrum (9/28/2012 at 8:41 AM)
I have long suggested a similar thing around end of life, since 90% say they want to 'die in peace' yet roughly 15% do, according to the commonly held definition. What the nascent 'conversation' around end of life really addresses is dying AT peace; dying IN peace is an obstacle course littered with impediments to dying both in and at peace. A 3-hour day would position people to add a range of things to "the talk". A 6-hour day would give them a depth of understanding that might truly empower them and change the future course of their, and their loved ones', demises. Since end of life is the caboose on life's train, I think Cheryl's car will get going first. Just be sure that the training (hey, that's a pun) includes more than describing what is; it must provide empowering guidance for how to manage.

deb (9/27/2012 at 5:59 PM)
This looks like yet another way the current system is going to exert control over what people do and who is allowed to provide "services." The insurance industry exerts control by their contracts - what they pay for and how much they pay for - is a means of controlling actions. "Responsibility" as it is currently used really means did a patient do what they were told to do - with little regard for whether those directions achieve what the patient may want to achieve. How about instead the control is actually shifted to the people seeking support for their well-being? (and yes, some people won't care, and for some that may be a viable choice) The concept of stewardship would go a long way here. Stewardship shifts control. Equip and empower people to be stewards, to make effective decisions for themselves for the sustainability of well-being - from a range of decisions available, not just a small list from the allopathic world. That's like teaching someone to fish . . . and offering the world of lakes and rivers.




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