Take 'Healthcare 101' and See the Doctor
What the course should teach
There's probably some truth to that argument. But I argue back that we should try to fix this.
In my hypothetical Healthcare 101 curriculum, there'd be sections on licensing and certification credentials so patients would understand competency differences—say, between a nurse practitioner and a registered nurse.
There'd be a brief section on how the Patient Protection and Affordable Care Act is changing payment incentives, which is changing the way hospitals and doctors provide care—imposing penalties for readmissions, infections, hospital-acquired infections, and other conditions, and establishing core measures of care. I'd spend time on rating systems, like those offered by Consumer Reports and Leapfrog Group, so consumers are more likely to shop for quality.
They'd see why these things are important and how many dollars are associated with performance. And that health consumers play a critical role in that process.
And they'd learn that doctors shouldn't provide healthcare through instinct alone because there is science and rules to what constitutes proper care. They'd hear why an antibiotic will do nothing to cure a viral cold, and the difference between clinical trial evidence and what a relative swore about herbal therapy or high colonics. (It continues to amaze me that even some of my most well-educated friends don't get this at all.)
By the course's close, patients would better appreciate how healthcare is a fast-paced business where the services that a doctor wants them to have—say a test or a drug or a procedure—may not be what they need or want, especially if they knew the alternatives and potential downsides. The phrase "informed shared medical decision" would become part of their lexicon.
They also might come to appreciate how smoking or being overweight increases their chance of requiring expensive, acute care and an early grave. It's far less "que sera, sera" and much more about choice.
What do you think? The accredited patient. It has a nice ring to it. Class dismissed.
Cheryl Clark is senior quality editor and California correspondent for HealthLeaders Media. She is a member of the Association of Health Care Journalists.
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