Who owns your “patient empowerment”? – Musings of an NYC Dermatologist

The coming July 4th weekend brings to mind the topic of patient empowerment. When one reads about “patient empowerment” in the media, it often refers to technologies that make it easier for patients to directly contact the doctor or the health facility. It often refers to a texting app or a messaging portal. The idea that having a variety of communication tools and direct access gives the patient more power and therefore better health outcomes. Ironically, this isn’t always true.

Technology is not our power. Technology is a tool we can use to express our power. Sometimes it helps us get the results we want. Sometimes it doesn’t help. Many of the modalities that are promoted as providing “patient empowerment” ironically give patients a false sense of powerlessness and unexpectedly damage the doctor-patient relationship.

An example would be the patient who is using an app to text her doctor about an insurance issue. The technology promises that the patient is “empowered” because she has this direct and instant access. It is implied that the doctor’s response, and resolution of the issue, should also be immediate. Many times, however, instant solutions are not in store.

Just because a message can be sent to a doctor immediately does not mean it can be responded to immediately. A doctor in the middle of a patient care visit may choose to respect the patient in front of her by not interrupting his visit by responding to a text message. After hours, the doctor may not have access to the resources to address the non-urgent issue. If the message had been sent to the office or during office hours, it would have been more quickly addressed. Even if the doctor is addressing the issue immediately, the response may not be immediate, as he or she may need to consult other parties to resolve the matter. A patient who doesn’t understand this may get unnecessarily offended.

The resolution of a patient concern is also sometimes delayed because the technology encourages patients to “engage” with their doctors, instead of the appropriate parties (i.e. insurance companies or pharmacies), about matters over which the doctor has no authority. “Is my prescription ready?” “Why do I have a deductible?”

Technology is a great servant but a terrible master. Sometimes it helps patients get what they want. Sometimes it delays them getting what they want. It’s also important to consider that sometimes it is introduced into the health care process not to empower the patient but to empower technology companies and administrators to more efficiently capture patient communications for data collection businesses—at the expense of the efficiency of the patient’s care. Make sure the technology you use can give you the results YOU want.

Power comes from within you…there’s no app for that.

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