Along with everything else in the world, the Information Age is changing the way health care is being dispensed. For the more traditionally oriented this is a somewhat bitter pill to swallow. For others it’s like a new lease on life.
In 1597 English philosopher, statesman and scientist Sir Francis Bacon pronounced: Ipsa scientia potestas est. Knowledge itself is power. The saying makes sense in a number of situations. No more so than in the ‘traditional’ doctor-patient relationship.
There was a time when the doctor’s will, and word, took precedence over any other source of treatment or patient input. With the availability of information being just a mouse click away the move is on for patients to re-claim what is rightfully theirs.
Namely setting the agenda for their own health and wellbeing.
One where a patient seeks help from a doctor, or healer, whose decisions were religiously adhered is now viewed by many as pure paternalism.
A model where unchecked physician paternalism abides, or where unlimited patient autonomy takes precedence, would quite rapidly produce revolt. Instead a more communication based ‘caring and sharing’ model has evolved that has been called ‘Patient-Centred Care’, or ‘Person-Centred Care’; in some countries it is called ‘Participatory Medicine’, and in some areas described within a wider concept of e-patient developments.
While the technology existed prior to CoVID-19 disrupting the world (from December 2019), on-line consultations between doctors and patients and the concept of the ‘e-patient’ rapidly became normalised. The principles are even being applied to situations where care is given with some revolutionary, and disruptive, ideas that have affected the design, and build, of facilities.
As with everything else in the world the conventional doctor-patient relationship has undergone quite massive transformation particularly in the ‘prescription’ of information.
Previously any sharing was largely to encourage a patient to agree with a particular course of action rather than putting forward an alternative view point.
Global business services group EY (Ernst Young Consulting) believe that patient centred care / person centred care / participatory health is reflective of a deep and profound shift in perspective around health toward well-being and wellness, greater convenience, flexibility, self-direction and personalised experiences.
But most importantly, the tools of participation in their own health care decisions open consumers to a world of alternatives that the emerging digisphere, social media and affinity networks will enable.
New entrants, new funding routes, ultimate choice and highly deregulated social constructs open new pathways toward health and wellness.
The first real challenge to the ‘asymmetrical’ approach came during the last 20 years with the push for a more active, autonomous patient or person-centred approach. One described in a 2019 thesis (Medical Students’ Perceptions of the Doctor-Patient Relationship) as where "the physician tries to enter the patient’s world, to see the illness through their eyes.”
More recently the trend, as described by the president of the United Kingdom-based Institute for Healthcare Improvement Donald Berwick, has created “the experience (to the extent the informed, individual patient desires it) of transparency, individualisation, recognition, respect, dignity and choice in all matters, without exception.”