Photo credit: Alex Proimos/Creative Commons
A while back three of us assembled to talk about the idea of patient-centricity. We’d been brought together as part of a roundtable discussion about how patient-centricity was interpreted differently across the healthcare industry. Our goal: To articulate a core, unifying concept of patient-centricity.
Despite our diverse backgrounds—one of us works at a medical technology company, another at a major healthcare provider network, and the third at a pharma advertising agency—we quickly found that our definitions of what constituted true patient-centricity were remarkably consistent and that we had each experienced similar frustrations in bringing those ideals to bear in daily practice. We also found that when it came to the issue of patient-centricity, each of us harbored at least a hint of cynicism.
To start, we questioned one of the frequently stated premises of patient-centricity—namely, that “putting the patient first” is the solution to all of the challenges facing the U.S. healthcare system. While the patient has an important voice in the healthcare process, at the same time it’s important not to forget that patients are people. And people continually make bad decisions with negative implications for their health. They eat the wrong food. They don’t exercise enough. Even when they do seek care, the data show that in many cases they don’t take medicine as directed or follow other therapeutic instructions.
Most people, us included, don’t want to be patients. Patients get told where to sit, when to stand, and even when to take their clothes off and when they can put them back on. They are scheduled, weighed, and probed.
Still, we really want patient-centricity to work. We like the idea of challenging the status quo and reminding ourselves that each of us is here to serve the interest of fellow human beings who, in many cases, have simply drawn the short straw. The better we can help them understand and take control of their care, the better the chance for a good outcome. Similarly, the more attuned we are to their values, fears, and aspirations, the more efficiently we can direct our resources to achieving their therapeutic goals.
That’s why we’d like to drop the pretenses and call out the differences between the discount patient-centricity that gets dosed liberally in most healthcare discussions these days and the ideal of patient-centricity that I think most of us intuitively understand. To that end, we propose two observations and a set of rules.
Observation #1: Patient-centricity may be as much about us as our patients.
Of all the aspirations that have been lumped within the patient-centric concept, its truly revolutionary aspect has been its impact on the healthcare providers, manufacturers, and payers who have adopted it. Even allowing for misinterpretations, the patient-centric movement has made everyone in healthcare more attentive to the patient perspective – and how can that not be a good thing? As an industry friend observed, “Suddenly the culture has changed from one that historically said, ‘This is what we have,’ to one that asks, ‘What do you need?’”
Observation #2: Patient-centricity needs to be about balancing interests and perspectives, not putting one—even the patient’s—above all others.
No sane person would say that the patient should have the final word on all healthcare decisions. It will never be a good idea for patients to, say, write their own prescriptions or have self-admitting privileges. The important thing about patient-centricity is recognizing the disadvantage patients are at as both outsiders and victims of disease or injury. The goal should be to balance patients’ interests and inputs among the many involved in the healthcare process and to ensure that they can be informed participants in their care.
As for The Rules, these are the things that real people really want from the healthcare system when they are a patient:
“I want to be cured:” Help me get back to whatever my ideal is for being “well.” Part of this involves understanding what constitutes “well” in my world. Hint: it may not have anything to do with the endpoints in your clinical studies.
“I want clarity:” Help me understand what’s going on with me, what you hope to accomplish, how you plan to do it, and how we’ll measure our success.
“I want confidence:” Show me you have the training, resources, technology, and whatever else it takes to get this done. Let me hear from other trusted voices and people who have been through what I’m going through.
“I want community:” Give me people who I can get to know and trust, who will share my journey and who I believe are committed to my health and well-being.
“I want you to be considerate:” Treat me like a real human being, not just another cog in the system. And don’t be judgmental—you don’t know the path that brought me here.
“I want it to be easy:” At the end of the day, I want as few demands as possible placed on me. Behavior change and preventative medicine sound good in theory, but I’d rather have a silver bullet.
With this we believe that we’ve articulated a concept of patient-centricity that brings it back in line with the patient-centric ideal that most of us understood intuitively when the term was first coined—and is equally relevant regardless of where in healthcare one works.
Jo Seidler is senior communications strategist at Philips Healthcare. Michael McLinden is senior healthcare strategist at Mck2x. Steve Herskovitz is director of communications, marketing, and education at Massachusetts General Hospital’s Cancer Center.