Patient engagement is the holy grail of health care

For health care professionals, patient engagement is the holy grail of health care.  It is the key to patient adherence – a prerequisite to achieving better outcomes, fewer ER visits and hospitalizations and more satisfied patients.  It is easy to recognize an engaged patient – they do what their health care providers recommends …what their health care team knows what is right for them.

But doesn’t engagement depend upon your perspective?

In a earlier life I spent a lot of time looking at health behavior.  Among the many things I learned were the following:

  • We all define health within the context of our own lives and in our own way
  • We all are satisfied with different levels of health

Admittedly there are patterns of health behavior or archetypes which can be used to segment health populations.  One such archetype is characterized as 1) placing a high priority on achieving a high level of personal health, 2) being very proactive in terms of achieving and maintaining their above average health, and 3) having a moderate to high distrust of the medical professionals.

Not surprisingly, people who shared this pattern of health-related thinking demonstrated lower levels of physician visits, fewer hospital and ER visits, lower health care costs.  They were also the healthiest when compared to all other patterns of health thinking and behavior.   Because of their trust issues with their providers, these patients were “mavericks” doing their own thing when it came to staying healthy.  In other words they were not very compliant and would be considered unengaged from the perspective of health care professionals as defined above.

People can be engaged in their own health and never see a doctor, visit a hospital, or take a prescription medication.

If you were to tell these independently healthy folks that they were “not engaged” in their own health they would likely scoff and say “what do you expect … the health care industry doesn’t take the time to understand the patient’s perspective.”  In truth, aren’t people like this doing a better job than the health industry when it comes to “engagement” and staying healthy?

The point is that we as health care professionals need to start looking at things like the definition of health, health goals, compliance, and outcomes from the patient’s perspective.  We need to incorporate the patient’s perspective into outcome and satisfaction measures.   Only then do we have the right to “judge” whether a person (aka patient) is engaged, activated, or empowered.   Once the health industry gets past this paternalistic, “we know better than you do” attitude then we can expect to see real change in health behavior and outcomes.

Steve Wilkins is a former hospital executive and consumer health behavior researcher who blogs at Mind The Gap.

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