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Take 'Healthcare 101' and See the Doctor

Cheryl Clark, for HealthLeaders Media, September 27, 2012

Nanny state

I know: "That sounds silly, awfully nanny-state." So offer people $200 off their health insurance premium, and I'll bet they'd volunteer. They could even take the course online.

After all, everyone has to take a class to get a driver's license. And incentives are common: a few years back, after I was ticketed on the freeway and lost my appeal, I had to attend a course for two days to avoid a hefty fine. (I chose "Comedy Traffic School," taught by a nightclub standup, to at least get a few laughs out of the experience.) Come to think of it, my car insurer said I could get a $50 credit on my premium if I took Geico's class in defensive driving.

Heck, I was even told that I couldn't operate the high-end quilting machine I coveted unless I took a course held by the manufacturer, Bernina.

Healthcare is surely a more critical and complicated issue than quilting, and it's certainly as important as driving a car.

This "Healthcare 101" thought came as I browsed through a survey published this week by the Institute of Medicine, Kaiser Permanente, and Consumer Reports, which partnered on a project regarding the state of physician-patient communication.

The thrust of the report, Communicating with Patients on Health Care Evidence, is that patients must demand a much greater role in making decisions, in cooperation with their providers—but that providers need to step it up to make that happen.

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4 comments on "Take 'Healthcare 101' and See the Doctor"


Eve Harris (10/1/2012 at 8:28 PM)
This strange (facetious?) suggestion is NOT patient-centered and does not actually empower patients or do much of anything to fix the broken healthcare delivery system.

Bart Windrum (9/28/2012 at 8:41 AM)
I have long suggested a similar thing around end of life, since 90% say they want to 'die in peace' yet roughly 15% do, according to the commonly held definition. What the nascent 'conversation' around end of life really addresses is dying AT peace; dying IN peace is an obstacle course littered with impediments to dying both in and at peace. A 3-hour day would position people to add a range of things to "the talk". A 6-hour day would give them a depth of understanding that might truly empower them and change the future course of their, and their loved ones', demises. Since end of life is the caboose on life's train, I think Cheryl's car will get going first. Just be sure that the training (hey, that's a pun) includes more than describing what is; it must provide empowering guidance for how to manage.

deb (9/27/2012 at 5:59 PM)
This looks like yet another way the current system is going to exert control over what people do and who is allowed to provide "services." The insurance industry exerts control by their contracts - what they pay for and how much they pay for - is a means of controlling actions. "Responsibility" as it is currently used really means did a patient do what they were told to do - with little regard for whether those directions achieve what the patient may want to achieve. How about instead the control is actually shifted to the people seeking support for their well-being? (and yes, some people won't care, and for some that may be a viable choice) The concept of stewardship would go a long way here. Stewardship shifts control. Equip and empower people to be stewards, to make effective decisions for themselves for the sustainability of well-being - from a range of decisions available, not just a small list from the allopathic world. That's like teaching someone to fish . . . and offering the world of lakes and rivers.