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Who’s in Charge?

As a patient, do you consider yourself to be in charge of your health care?  Do you take the initiative to schedule your appointments, get your screenings and ask the right questions when you see your doctors or nurses? Do you make sure that you are getting your flu shot?


Do you keep a record of your immunizations, medications, procedures and family history so that you show up with your complete health information at the point of care? Are you one of those patients who goes online to research your health conditions,seek information and look for communities to discuss health issues?


Who do you blame for being overweight? Do you blame yourself for eating the wrong foods and too much of them, or your doctor for not giving you the proper advice about nutrition?


Who do you feel is at fault when you do not comply with a medication regiment that the doctor has prescribed, the doctor or pharmacist for not explaining all of the significant details about the medication or yourself for failing to adhere?


Are you an engaged patient or are you a passive recipient of  health care?


Patient engagement has  been receiving serious attention. Recent healthcare legislation  mandates that patients must be engaged. Meaningful Use Stage II  that will go into effect in 2014 outlines four patient engagement criteria:


(1) You must have access to an electronic copy of your health information


(2) You must receive clinical summaries of all office visits with your physician within three days of the visit regardless of whether or not you request, or want this information. The summaries may be given to you on a CD, via secure email or a secure online portal, on a USB  drive or in a printed copy


(3)Your physicians must send you reminders about preventive follow-up care and appointment recalls.


(4) You must have timely electronic access to your health information within four business days of that information being updated in your electronic health record.


Patient engagement has been acclaimed by some as the Holy Grail in physician/patient relationships today.  Clearly it requires effort on the part of both the patient and the physician/physician assistant/nurse practitioner.


One of my colleagues in the Society of Participatory Medicine, advocates that  health coaching, focused on helping people  gain the knowledge, skills and confidence to become active participants in their care is the way to increasing patient engagement. The idea of attending a workshop to learn skills in order to become an engaged patient is a bit too much  for many  of us.However, it takes concerted effort and knowledge to take charge of your health care.


At the end of the day it is up to each of us to make that commitment, to foster a trusted relationship with a health care provider and to truly engage in health care choices and decisions.



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