“You are not a medical clinician. They won’t listen to you. The doctors won’t listen to you”. I was meeting with an accountant who works with a firm that offers services to health systems that include operation analysis and process improvement. I have prepared a business brief that outlines services I offer as a Patient Engagement Specialist that could help health systems – both hospitals and residential care facilities – reduce risks and improve outcomes related to patient engagement. I come with my own background as a patient advocate consumer with a book published in this field and I am part of wide number of national and regional advocacy advisory groups, bodies and boards focused on this very issue of patient engagement. This has become a huge issue for health systems, especially since these outcomes will be measured to determine payment options going forward. The Center for Medicare and Medicaid Services are driving this process. Did he know of people I could meet with? Did he know of consulting firms offering risk reduction services to health systems? This could be a natural fit for a proposal to a health system. And I was taken aback at his response! I had to be a medical clinician??! Better yet if I was a medical doctor. My PhD won’t cut it. I think he was giving me an honest response. Much is being made of creating greater connection between the patient/family consumer and health systems. Medical conferences now routinely have an obligatory panel called something like ‘the patient voice’. I’ve been on those. Endless articles address ways to create improved patient/hospital relations……. though many more need to be written about residential care facilities. Close to half of the hospitals in the United States have some form of ‘patient family advisory council’ and are opening offices and positions with such titles as Director of Patient Engagement and calling their patients ‘guests’. Are these authentic? A very recent poll conducted among hospitals in central Indiana shows that among the hospitals in this region who have developed some form of patient family advisory council, only one reported having the council co-chaired by members of both the hospital and non-hospital participants. An authentic attempt at this would be to have the councils co-chaired by a non-hospital participant. I can understand the concern of doctors who are somewhat leery of these councils and cautious about the whole new field of ‘patient advocates’. One medical director said as such to me: ‘who do they think I am? Jack the Ripper??! I care deeply about the patients and their outcomes!’. Yes, of course he does. But to suggest that I – as a patient consumer advocate – will not be listened to by a doctor because I am not a medical clinician suggests that we have a medical system that remains paternalistically controlled by physicians. Knock knock! This is changing. I believe that an increasing number of physicians are embracing this with genuine welcome. Are they outnumbered by those who resist the paradigm shift going on in health care that is screaming loud and clear that it is the patient who is in the driver seat? I will agree that just being angry and full of opinion does not make one qualified to sit at the table of policy change and behavior. Patient Family Advisory Councils are not places to blow off steam with a personal agenda or grudge. But when non-medical consumers come deeply qualified with training, background and experience and have done their own homework…. yes, doctors need to listen to them. Very carefully and with profound sincerity. Not with platitudes or fake attention, but with the serious intent that what we have to say not only matters, but is being measured and taken seriously.
Betty K. Tonsing, Ph.D., CLSS