A glance at the statistics reveals the growing proportion of patients in western countries who are over 65, retired, and relatively uninformed about their disease and treatment options. They trust professionals to provide them with the appropriate care.
In certain sectors of society, however, this situation is in decline: patients want to take more control and are not prepared to play the passive role.
Main drivers
The Internet and other mass media appear to have driven this rise of patient power, according to Mike Bloxham, chief executive of Netpoll. Health has climbed the news agenda. Rationing, hospital errors and doctors in court have all hit the headlines. Even hospital soaps increase awareness. There is generally more information on heath issues in the media, Mr Bloxham explains. In the UK there has been a focus on the NHS and patient rights, which has led to a greater concern of the reality of the health service and how it affects us.
The Internet, meanwhile, offers a vast array of endless information available at the touch of a button. A patient can easily personalize information or retrieve only relevant documents, narrowing down their search from the virtual library. In just a few clicks, a patient can access everything from simplified explanations to original research papers, then connect with other patients to share experiences.
The penetration of the Internet in the US and Europe has certainly fueled the rise of patient power. Indeed, health has replaced pornography as the most popular reason to access the Web. With the media and the Internet as support, patients increasingly find confidence to speak out.
The power of information
Patients can take information to their doctor and say, ‘This is my opinion based on this information – what do you think?’ Mr Bloxham continues, It is easier to enter dialogue now whereas it was mystifying previously – ranging from prescriptions written in Latin to medical jargon and the need to take all this in a seven minute appointment with a GP. It is difficult to challenge a GP but now the patient has more information they are more confident and more likely to challenge their doctor.
According to Mr Bloxham attitudes rather than demographics split patients into those that speak and those that stay silent. Some people will not challenge authority and are prepared to play a passive role. Others see an engagement with the doctor as a debate and will fight for their rights. Attitudes differ, but as it gets easier to access information it becomes easier to challenge and engage in conversation with the doctor.
Doctors orders
Many healthcare professionals are skeptical about the empowered patient. They point to recent studies, such as one conducted by the Consumers Association and published last year, that indicate much information on the Internet cannot be trusted. Healthcare information (excluding that from pharmaceutical companies) is not regulated, although certificates, like the Verified Internet Pharmacy Practice Sites (VIPPS) awarded by the National Association of Boards of Pharmacy in the US, do give a stamp of quality.
The UK’s Consumer’s Association also found that Internet users visit sites intended for medical professionals. These visits give the patient a greater awareness of the different treatments available on an international scale. Therapy specific sites such as those for multiple sclerosis (MS), for example, describe treatment options from an international perspective. But some treatments, like interferon in the case of MS, may not be globally available because of government restrictions in certain countries. A poor grasp of regulatory issues leads to tensions between the doctor and patient.
The future
Many professionals, however, have welcomed better informed patients. Some doctors like the patient to play an active role in their healthcare, taking an interest and talking to others. They may direct a patient to a good website that offers clear information and the facility to talk to other patients, says Mr Bloxham. This interaction should be encouraged, but not all doctors are familiar with the Internet. Netpoll’s research on how physicians use the Internet shows that many do not have the time to use the it, so do not think it has much to offer
Over time the nature of the consultation with the patient will evolve to become more of a two-way process, an exchange of information, an education rather than an active-passive relationship. Such a change will require new skills from the doctor but evidence suggests it will bear fruit. Research conducted in the US demonstrates that an informed patient is easier to motivate to comply with medicine, easier to educate on lifestyle issues and of course easier to engage in meaningful dialog about their illness. Informed patients appear also to take up less of their doctor’s time than uninformed ones.
Proactive patients should lead to more responsive healthcare provision. The customer is frequently told that they are king so why should this not extend to healthcare? Patients will increasingly shop around for a second opinion if they disagree with their doctor on an issue, or want access to an unavailable treatment. As it becomes easier to obtain information, the patient will become willing to explore alternatives. It is all about choice, concludes Mr Bloxham.
