New Paradigm: Patient-Centered Care
“Patient-centered care” when I originally heard that this is where healthcare is headed, my knee-jerk reaction was health care has always been about the patient, how is this any different? I questioned whether this was a new term or someone stating the obvious. As a former clinician having worked in multiple clinical settings, I was intimately familiar with how care is delivered. The focus was the patient or so I thought. Moreover, I instantly thought pharmaceutical and medical device companies develop products for patients. Why the need to become more patient-centric?
Delving down further (both into the literature and my own history), it becomes quite apparent that traditionally health care has not been about treating patients but rather managing physiologic systems. When a drug, device or procedure relieves the signs and symptoms and the patient’s “numbers” look good, the patient is declared to be “managed” or “under control”. This is even if the patient is less than satisfied about the treatment due to issues of adverse effects or inconvenience.
While many in health care value the team approach, ironically most often the most critical team member, the patient, was missing. How therapies impact the patient’s lifestyle have been largely ignored as well as non-medical approaches to disease management. These interventions have long been assumed as necessary components of proper care for a variety of conditions both chronic and acute. Physicians were not compensated to discuss things like diet and exercise (and did not really know how to guide patients anyway), and therapy companies did not want to take the attention off of their products. Lifestyle choices tended to fall by the wayside across the spectrum of the industry. For example, it has been shown that diet and exercise is often the most effective treatment for controlling diabetes when patients exhibit a sedentary lifestyle and obesity. Furthermore, most large corporations even those which have no direct business in healthcare have implemented fairly extensive in-house wellness programs are realizing the value of lifestyle interventions. Through on-site fitness centers, dietitians, health assessments, and weight loss and smoking cessation programs companies such as Verizon and Apple are helping their employees to live healthier lives. There are financial benefits to companies having active and healthy employees. Many large corporations self-insure and are keenly aware of the costs versus benefits.
According to the Institute for Health Care Improvement, practicing patient-centered care puts “the patient and the family at the heart of every decision and empowering them to be genuine partners in their care”. This includes consideration for their cultural traditions, personal preferences and values, family situations, and lifestyles. It ensures that transitions between providers, departments, and health care settings are respectful, coordinated, and efficient thus potentially reducing unnecessary services. This translates to a collaborative relationship between the provider and patient. Here, the primary provider is not just the “gate-keeper” who shifts the patient to multiple specialties in an uncoordinated fashion, but a true partner who can call upon members of a team (including specialists) to make certain that the patient not just the disease, is effectively treated.
What this means to our industry is that it is no longer business as usual, rather:
- We can no longer just promote therapy alone.
- Physicians alone (particularly specialists at early stages of marketing) are no longer the only prime target with other clinical stakeholders considered only as “influencers”.
- The patient must be part of the equation when it comes to product development and how it is rolled out into the market.
A number of forward-thinking companies have been taking the lead. These are the ones who have already spearheaded or are developing programs that concentrating on the value that they as a company can bring to patients rather than how much physical product they sell. Others started or acquired completely new lines of business which complement their product offerings. Case in point, Merck recently launched a weight management company. Being a service, this is a certainly a deviation from what might have been considered their core business, however this offering works quite synergistically with Merck’s diabetes franchise. Weight loss can only help an anti-diabetes agent to work better.
Beyond those examples, there are a myriad of ways that the industry can not only adapt to this positive change in health care, but to use it to successfully evolve.
Please check out our next blog where we discuss some key players in patient-centered care that industry needs to keep an eye on.