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Are We Consumers or Patients? Depends on Who You Ask

April 3, 2013
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In the last few years, the related concepts of patient engagement and consumer eHealth movement have garnered a lot of interest from the government, private companies, provider organizations, and a variety of different stakeholders. Heck, as I wrote last month, it was one of the core backdrops of this year’s industry-wide HIMSS conference.

At the center of the broader movement towards empowerment of consumers and patients is the belief they should be equal partners with their providers in their healthcare, specifically in this case, through the use eHealth tools. In this regard, empowerment is based on the idea that the patient is not merely a recipient of healthcare, but a consumer. Just as you go to an electronics store armed with information on the latest computer to buy, the people behind this movement believe you should go to the doctor armed with information on your medical history.  

In this ideal world, the patient and the practitioner compare notes, share information, and jointly decide the best course of action. And everyone lives happily ever after.

Ok, maybe not everyone. As I was reminded this week, when I interviewed Paul Keckley, Ph.D., executive director for Deloitte Center for Health Solutions, not everyone is a believer in the notion that the patient is a consumer.

Keckley, who was talking with me about a recent report that he authored with a few others on physicians’ overall attitude on the direction of the medical profession, made it clear that many doctors consider the consumer eHealth movement to be nothing more than a fool’s paradise.

“Doctors are generally frightened by [consumer eHealth],” Keckley told me. “They think consumers are ill-equipped to manage information, much less engage in their own health. Most doctors like to think of them as patients, not consumers. They like to think the patient is dependent on the doctor and that gives them a sense of control over the patient. This notion of connectivity and consumerism kind of rubs them the wrong way.”

To be clear, Keckley didn’t attribute these sentiments to all doctors. He noted a good plurality, especially younger docs, are on board with the consumer eHealth movement, and advocate for the related technologies. Yet his point remains: many do not like that term consumer and are not ready to change the traditional paternalistic patient-physician relationship.

It’s a debate that I’ve seen pop up from time to time. There have been pieces on the changing terminology and the implications of an empowered patient. I understand the backlash and can see instances where the patient being an equal partner could backfire (the last link I provided has a few examples). Still, I’m a firm believer in this movement and I hope more doctors can get behind it.

As healthcare moves to reimbursement-based on outcomes, this partnership, and the sharing of information between both parties, is vital. Allowing patients to act as empowered consumers and encouraging them to view their health record will, quite simply, get them more involved. If they’re more involved, they’re going to better self-manage their health.

Don’t take my word it. Check out this recent study from researchers at Oregon Health & Science University and the Portland VA Medical Center. Researchers in the study conducted focus groups of Veterans who participated in the patient portal-based My HealtheVet Pilot, from the Department of Veterans Affairs (VA).

They found that veterans who viewed their health information through this portal found that it improved communication between them and their doctor, enhanced their knowledge of their health and improved self-care, and allowed for greater participation in the quality of their care, such as follow-up to test results. Overall, having more information, provided benefits.

Is this always going to be the case? Of course not, and I’m sure some of the worries stated above will come to fruition. But in general, it’s just plain wrong to assume patients are incapable of helping themselves through the power of information, and being partners in your healthcare.  As Keckley said, with the reimbursement shift in healthcare, empowering patients through these health IT tools, will become the standard.

If that means patients are consumers, then so be it.

Thoughts? Feel free to leave comments below or respond to me on Twitter by following me at @HCI_GPerna.



You bring up quite a few valid points and some food for thought in this post Gabriel, thanks for writing it.

It seems on the one hand that advances in the quality of care can't happen unless patients take a more vested interest in their own data, throwing more skin in the game and being more accountable for themselves. Then on the other hand, some doctors embrace this but others don't want to lose their "paternal" patient relationship with patients and feel that ehealth is all a farce.

We don't feel that healthcare can achieve the goals set forth in Meaningful Use unless the Dr-patient relationship changes and becomes more symbiotic. Those Dr's that rally behind the "eHealth is a "fool's paradise" mantra are missing an opportunity to help push the industry in a direction that enables more efficient, quality healthcare with a larger potential to impact more people than simply the patient themselves.

What a shame that there are those who hold what could be considered as a narrow minded view.

Completely agree. It's very sad that it's such a black and white view, and some of these people can't just move to the middle a little bit. Those doctors will rail against this movement, and say how it doesn't work, but they won't even try it out, and because of that, it won't work. Thanks for your comments RightPatient!