Real World Health Care Blog

Speaking Up: Let Patients Have a Say

One of the main tenets of patient-centered care is giving patients more control over their health and health decisions made on their behalf. Patients have a clear and important role in their own care through a concept called “patienthood” — the self-management behavior that ensures we either give to ourselves or get from others the care we need to manage our health risks and medical problems.

Linda Barlow

Linda Barlow

On the surface, patienthood seems like a simple concept: our body, our health, our decisions. What might be right for the patient next door may not be right for us. At one end of the spectrum, patienthood may involve strategies like eating right and exercising to avoid problems related to obesity. At the other end of the spectrum, it may involve saying “no” to certain suggested treatments, as I did when I opted not to have chemotherapy after my breast cancer operation.

According to a report from Kaiser Health News, in many hospitals and clinics around the country, health care professionals simply tell patients what treatments they should have, or at least give them strong recommendations. But at UC San Francisco, a formal process called “shared decision making” allows patients to work with doctors to make choices –regarding their care. The approach has become a model for other programs around the country.

The report mentions a stumbling block to this approach: many patients aren’t accustomed to speaking up. Even the most engaged or educated patients may defer to their doctors because they are scared, they don’t want to be seen as difficult or they think the doctor knows best.

Doctors who recognize this stumbling block may want to take a cue from one family doctor profiled in the Washington Post who, when faced with a medical conundrum involving an elderly patient, pushed aside talk of possible treatments and asked the patient a simple question: “What are your goals for care, and how can I help you?”

This particular patient wasn’t looking for a cure. He simply wanted to live out his remaining days at home without worrying about falling. So the doctor put together a hospice and physical therapy plan that let him do just that.

Patients speaking up. Doctors asking the right questions…and listening to the answers. Patients and doctors deciding together on a course of care or treatment. The concept of patient-centered care cannot be fully realized until everyone involved has a say.

Have you ever played a role in deciding on your own course of treatment? Or do you typically hesitate to speak up to your health care providers? Let us know in the comments section.