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Debate: The healthcare system must partner with the patient

Patients possess knowledge that healthcare professionals must make much better use of during the patient's course of treatment.

2016.02.22

By Allan Flyvbjerg, Dean of the Faculty of Health, Aarhus University

The media likes good stories like the one about the health policy maker, hospital director or senior hospital physician, who is admitted to one of their “own” hospital departments and then gets to experience the healthcare system in a new “bodily” perspective. In real life. I’ve tried it and it was a real eye-opener to see the healthcare system lying in a hospital bed. Even though I was the natural focal point, it felt like I was being condensed into a diagnosis dressed in white.

It is thought-provoking that the patient, who is the person most involved in the course of treatment, is also often the last person to be involved – if, indeed, he or she is involved at all – in the deliberations and decisions on the further course of action.

This is both unwise and a waste of an extremely important resource, namely the patient. The patient is the key figure and, as such, should be involved throughout the process from diagnosis and treatment to rehabilitation. It is not just a question of generating satisfaction with the service that the patient meets. We know from studies that treatment outcomes are improved when the patient takes ownership and is involved in the core service itself. Having an overview of your own illness is good for your health. But it needs to be done systematically and patients must never find themselves in a position where they are the one with responsibility for a decision that they are not equipped to make.

Professorship in patient involvement

In 2013, Aarhus University and Aarhus University Hospital created a professorship in nursing to carry out research into patient involvement methods. The goal is to invite the patients to enter into partnerships in which they work together with doctors, nurses and other healthcare professionals to identify symptoms and – on an informed basis – become involved in choosing the examinations that are relevant in their particular situation. The patients decide the type of treatment in collaboration with the healthcare professionals, and they can choose which part of it they can and will carry out in accordance with instructions from doctors or nurses. This is especially helpful for patients with chronic diseases or conditions requiring long-term treatment such as delayed complications following cancer treatment.

Another dimension of patient involvement is also avoiding wasting the patient's time and resources. Making patients come to routine check-ups at regular intervals does not make sense without taking the needs of the patient into account. Everyone finds it a waste of time if there is not really anything to discuss or test. On the other hand, it can be difficult to find time when there is actually a need for it.

Improved use of resources

When discussing patient involvement, there are often cautionary voices that contend that patient involvement is just a new concept to cover up savings in the healthcare system. It is also true that personnel savings can be made with e.g. new technologies such as an app in which the patient can register their symptoms or treat themselves after watching a video tutorial. It is also clear that patient involvement is made even more topical by changing demographics. We live longer – and we do so with diseases that would have been fatal just a few years ago. In this way there is talk of an altered and better use of the resources in the healthcare system.

Getting to grips with such a large and unmanageable area as patient involvement can appear to be a difficult task. But as can be seen in this article, it can also be very simple. Nevertheless, there is talk of a paradigm shift in the way we perceive the patient, which will present a particular challenge for conventional thinking among employees in the healthcare system. The patient goes from being an object for the healthcare professionals efforts to being an active resource and partner who has an equal role in relation to both decisions about and planning of a course of treatment. This inclusive approach will also contribute to a patient process that is both experienced as – and is – coherent.

Collaboration, Health and disease, Health, Health, All groups