A recent New York Times article predicted that accountable care organizations (ACOs) and similar care consortiums will completely upend health care delivery in the United States by 2020. While that’s provocative speculation, physicians and other care providers practicing in population management entities do need to ramp up their ability to explain new health care delivery models to their patients. In doing so, they will want to pay particular attention to increased expectation for the patient’s participation.
A key requirement for ACOs and similar entities is more fully engaging patients in their health-related decisions. Exactly how to achieve that goal is still a bit murky, but the essential component is enabling patients to conduct well-informed discussions with a coordinated team of providers about their health, care options, and medical decisions. The expected consequence is that patients who appreciate the more focused and synchronized approach to their care will make informed decisions that benefit both themselves and the overall population. An additional benefit is that a more engaged patient population serves as another layer of patient safety protection.
Of course, a patient’s motivation to be engaged in her care can be counterbalanced by skepticism if she doesn’t perceive a direct benefit. Friends, family, and the popular media may influence an attitude that patient engagement is just a new tactic for advising everyone to diet and exercise more often. And, even without any external influence, change may engender frustration or distrust for some patients.
For example, decisions regarding what tests are ordered, what consults or referrals are proffered, and what treatment or medications are recommended, may be challenged. Increased access to medical records may introduce unfamiliar terms or information displays that trigger requests for clarification. How you answer your patients’ questions will be a key aspect of their attitudes toward engagement and a healthy physician-patient relationship.
Jock Hoffman is the Patient Safety Education Program Director for CRICO, the malpractice insurance provider for physicians and hospitals affiliated with Harvard Medical School.
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