In addition to visiting doctors, worrying about test results, calling the hospital, and wishing it was not so hot, I have managed to swim in the local river for the first time in years. It was glorious! I hope you too have found time to something you enjoy as you wait for autumn.
Today’s blog topics:
– Fixing the healthcare crisis: patients as equal partners
– Questions to empower patients
– Data versus assumptions – a personal observation
– Leadership: the importance of role awareness and reflection
Fixing the healthcare crisis: Patients as equal partners
Around the globe healthcare costs are on the rise, limiting access to treatments in many places as governments worldwide seek cost-effective care solutions. In a recent newsletter, I highlighted Singapore’s innovative healthcare model which performs comparably to Switzerland’s system at a quarter of the cost (link to article). The difference? Patients benefit directly if they use less healthcare resources.
However, while beneficial, I don’t believe that focusing solely on financial incentives to consume less will be enough in the longer term. The global shortage of healthcare professionals (HCPs) translates to less time per patient, the risk of mistakes and less time for conversations with patients. Despite everyone’s hopes even if AI does take on routine tasks in the clinic, physicians will be asked to see more patients, not to spend more time with individual patients.
Healthcare professionals do their best, they work under difficult circumstances, but, given that no one is more invested in a patient’s health than the patient themselves, and that pressure on HCPs looks to increase, maybe it is the right time to empower patients to take a more engaged role in their health management by giving them easier access to information. Currently, accessing information beyond prescription details is challenging for non-HCP patients. Whether seeking original clinical trial data and publications, or pre-emptively researching a product, such information is often available online, but the key lies in a patient’s ability to find it. Another resource, pharmaceutical industry medical information departments, often does not cater to complex patient inquiries. Typically, patients who contact pharmaceutical companies with questions about their prescriptions are referred to their clinicians.
Especially in markets with direct-to-consumer drug marketing, I think it is worth considering that patients are permitted to query pharma companies about products they have been prescribed or that have been proposed as treatment options, so that they can reach an informed position and compile a list of questions before the next appointment with their clinician.
While not every patient will be interested, or indeed able, to manage their health more actively many will be, as shared by patient advocate Suz Schrandt when she told me in 2017 about the information she would like to access as a patient but struggles to do so (link to article medical Information patient needs). As we navigate a new era in healthcare, I suggest that it is time to give patients the opportunity to take more ownership in managing their health by removing access restrictions to relevant information.
I realise this may be a controversial position, so I am interested to hear your opinions.
Key takeaway: Resource constraints limit access to healthcare services as time pressures increase on HCPs. Engaging patients more actively as managers of their health by giving them access to key information could improve patient health and through patient engagement also potentially improve compliance.
Questions to empower patients
As a physician I often support friends and family members when they face healthcare challenges, usually once things look as though they are going wrong. This experience has made me think about the questions patients should have ready to ask when meeting their doctors to discuss treatment options. Naturally, the opportunity to ask questions and the available choices will vary depending on local culture, the local healthcare system and other local factors, however, regardless of the system I believe in being prepared.
I recommend the following approach, especially when seeing a new doctor:
Start by making a list before you go to visit your doctor, if your doctor doesn’t have much time, you may otherwise find that you have left the practice without having all your questions answered.
List any recent symptoms you have experienced, what the context was and if they were reproducible. Ensure you have a list of all medications you are taking including any over the counter supplements you take,. If you are being assessed for surgery, ask about alternatives, risk factors, prognoses, the experience of the doctor performing the surgery, how often she has performed this surgery before and what her success rate is. Ask about typical outcomes, risk versus benefit for you personally and what the outcome will be if the operation is not performed. Also ask about timelines for operation, what is the urgency, is there any or can you delay? Also ask about considerations for managing at home post-operation and rehabilitation options. Finally, consider finding out whether doctors are incentivised to perform surgery.
Further questions to ask include whether there are medical treatment guidelines and whether the recommended treatment is in line with these guidelines. Ask whether your doctor thinks his colleagues would recommend the same approach, and potentially whether the doctor would treat his family in the way recommended. Depending on your situation it is also important to weigh the quality of life versus the impacts and benefits of therapy.
If you are receiving a new prescription ask about alternatives, pros and cons, potential interactions with medication you are already on, foods you shouldn’t eat while taking the medication and whether there is anything else you should be aware of, sensitivity to light for example, whether you can still drive and whether your can drink alcohol. Also ask about potential interactions with common over the counter drugs or other medicines you may take periodically such as antihistamines.
Depending on the market you are in, ask whether the prescribed medication is the best one for the condition, or whether it is currently the only one available in your market, or the only one that is financed in your market. If your doctor says there are better, newer products available, but they are currently not available in your market, ask whether you can be included in a clinical trial or whether there are other ways to access the product and whether this is worth looking into.
This isn’t an exhaustive list. If anyone has additional suggestions I would be very interested to read them. Please share them with me.
Key take-away: Nothing beats good preparation.
Data versus assumptions – a personal observation
I recently subscribed to Nature. Having spent years immersed in basic research, analysing promoter regions, experimenting with cell cultures, assessing protein expression levels, and generating antibodies, my love of science is an enduring one. In addition, I’m also a physician. So, when the mRNA vaccines were rolled out, one might have expected me to dive into the research, scrutinize the publications – though of course there wasn’t much available initially – and engage in deep contemplation. Surprisingly, although not within the context of the pandemic, perhaps, I didn’t. I got vaccinated and moved on.
What intrigues me about this situation is how I made many assumptions about the design of the mRNA vaccines, based on my background, only to discover upon reading Nature publications that I was mistaken. This serves as a reminder of how often we draw conclusions based on our unique perspectives without verifying the accuracy of our assumptions, often leading to surprises down the road. For more information on the history of mRNA vaccines Johns Hopkins has an excellent summary here
Key take-away: Data beats assumptions almost every time.
Leadership: The importance of role awareness and reflection
In my work with teams and leaders two recurring themes appear. First, the desire to make a meaningful impact and have contributions recognized. Second, the mismatch between expectations of others and reality. While issues vary, considering roles often offers insights.
Among the many aspects, I will focus on one factor that can be transformative: role awareness.
Role awareness starts with reflecting upon the roles we hold. We are children by birth, parents by choice, doctors by training, in my case, and general managers by successful navigation of the career ladder. Additionally, socialisation and valency prime us for further roles: the outspoken one, the caregiver, the problem solver, the paternal figure, and more. While companies employ tests like Myers Briggs, Belbin, and Insights to enhance performance and self-awareness, the significance of assumed and designated roles, coupled with adeptly handling role shifts, is often overlooked, yet critical for success.
Once you understand the range of roles you embody and adopt it is worth considering your work-related role. This includes assessing whether your understanding of your role aligns with the organization’s perspective. In the event of a mismatch here, or a lack of clarity, future issues are almost certain.
In addition to understanding the roles you inhabit; it is worth considering best practice in role initiation and role relinquishment as your career progresses. In practice, when taking on a new role, consider what this role requires of you and what you need to leave behind. To perform well in one role, you need to fully exit from an old role. If you do not, you risk confusion for yourself and your stakeholders. In addition, as long as you inhabit a role that you have officially left there is no “space” for the new role holder to succeed in it.
When role assumption and relinquishment are an issue, the situation might be viewed as follows by the manager, who was promoted from the role, stating, “I expected better performance and more autonomous decision making from the new role holder” and the new role holder saying, “despite the promotion, he’s still immersed in daily operations, and I cannot make any decisions”.
Key takeaway: Focus fully on the tasks associated with your current role and job title, step away from operative activities related to your old role to allow your successor room to excel. Provide guidance only as appropriate, i.e., if is part of your new role, or you have been asked to mentor
Thank you for reading, I enjoy sharing my thoughts and I love hearing what piqued your interest or any feedback and thoughts. If you are currently working on a demanding project in the fields of medical, digital, systems, analytics, channels, or facing team or personal challenges, feel free to reach out to me for an informal chat. I am always happy to explore how I might be able to support you.
Isabelle C. Widmer MD
Photo credit: Annie Spratt @Unsplash