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February 11, 2015 Readers Write 6 Comments

Patient Discipline, Or is it Simply Willpower?
By Helen Figge

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The dust seems to be settling a bit these days, with overwhelming sighs of relief about the redefining of MU2, ICD-10 continuing the saga onward but slower, and the unending chatter about the patient portal and how we need to get patients to use it in order to reap the benefits of the various regulations and mandates in place forcing doctor’s and caregivers alike to make us all healthier. Couple that to our worries that once we have the collected data, we then are able to analyze the data in a way that actually benefits the end user – you and me – the healthcare consumer. Just as worrisome is the safety of the data and its security.

The quandary to all of this at times is that we are still a very sickly society. More than one-third of US adults are obese. Obesity-related conditions include heart disease, stroke, type 2 diabetes, and certain types of cancer, which are some of the leading causes of preventable death. The estimated annual medical cost of obesity in 2008 was $147 billion, while the medical costs for people who are obese is about $1,429 higher than those of normal weight.

Surely we have many of the technologies in place to help counteract these serious statistics — various forms of health information technology solutions that actually can assist clinicians to take better care of their patients. The technology is in place, now we need to best utilize it, right?

One term continues to be said and that is patient engagement — engaging the patient to care, which is deemed as one of the cornerstones for healthcare success in making us healthier than ever before. The baseline theme common to many in the patient engagement framework is managing information and making it available to both the patient and care team in a manner that supports care decisions, improves bi-directional communication, and optimizes outcomes. This is the nirvana we strive to accomplish in healthcare, and we appear to be doing so as we move forward in time.

We are seeing more and more patient engagement opportunities available to the healthcare consumer. These are in the forms of weight loss programs, reminders to eat and exercise, Facebook clubs, and many other forms of enticing the patient to care.

Despite the benefits of patient engagement solutions and the investments currently being made, convincing the patient to care might be the more difficult aspect to all of this and will require innovation. Lack of health literacy in a large portion of the population, fragmented end-user market, poor access to healthcare, and security of patient data again stated are still hindering growth of this market to convince the patient.

These efforts boil down to one common thread: self-motivation or self-discipline by the healthcare consumer. Without the engaged patient, the various interventions prescribed by their caregivers will go unnoticed and fall short of the clinicians’ effort to effectively prescribe. But how do you self-motivate or educate a person on self-discipline and have it, not withstanding lifelong tendencies, become a normal part of one’s life?

I take myself as an example. I don’t know how many times on a cold, dreary day I rather would have laid in bed than get my running shoes on and take a quick two-mile run up and down the road before any of the neighbors saw me, thinking to themselves, “What is she doing out in the dark with a flashlight in this hour?” It’s because I work for a living and I had to fit my run in before work and before life started.

But in the end, I did it, and do so faithfully. I disciplined myself knowing it was good for me. The alternatives are less than appealing. Forget that the doctor that says it is good for your blood pressure and weight and bones or the envy or guilt often times put on us by our peers because they do it. I do it for me and the motivation comes from within, not someone reminding me it is good for me. That is the discipline we need in healthcare as consumers if all of these tactics to entice us to take care of ourselves takes hold.

In order for patient engagement to work and before entities heavily invest in programs and concepts to “educate” the consumer about their health, we need to get to the root cause of self-discipline. Someone needs to understand how we discipline ourselves to take care of our health. That is where sustainable healthcare lies for us now and in future generations — teaching us the discipline, and in turn, the next generation.

Eventually we will not have the ability to be reminded to take care of ourselves by an outside party. Funding may run out, people may tire of the phone call to eat right that day or sustain from a cigarette else you will end up on oxygen and die a slow and painful death. We will need to learn from these efforts via patient engagement tactics, and in turn, use those pieces of information to further our own reasoning of, “Why do I need to do it?”

Whether it is home glucose monitoring, INR readings, blood pressure readings, or any of the other mobile device readings, what we do with the data to infuse the practices into everyday life will determine the long-term outcomes of healthcare success. Determining the outcomes of all of the healthcare reforms, reimbursements, and penalties really come down to one simple fact: will the healthcare consumer heed their doctor’s advice, listen to directions, and follow the protocol to keep them alive, make them well, or to keep them well?

It boils down to discipline. Are you disciplined enough not to be reminded to take care of yourself, or are you like most Americans who need to be cajoled, bribed, and threatened in order to take control of your own health destiny? Only your self-discipline can answer that question.

Helen Figge is SVP of global strategic development for Lumira.

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Currently there are "6 comments" on this Article:

  1. Great points here, I often wonder how you can have two very similar individuals in status, education, even upbringing yet their self discipline or motivation to lead healthy lives is drastically different. I think self discipline is something that may be partly genetic, something other family members share. But, I also believe for those who do not encompass this inherited trait, it can be learned but only over time and with an aggressive approach.

  2. Too often we all speak of patient engagement in this industry but are not focused on the actual intentions and psychology of the patient; what will work to keep them engaged and (more importantly) making permanent lifestyle changes to stay healthy. It’s important for us all, within this industry, to get to that point in order to ‘break the code’. Great article!!

  3. While I don’t dispute the intent of your article, I am appalled that you used obesity as an example. Obesity is a multifaceted disease that is not always caused by overeating and lack of exercise. For many people it’s not enough to eat right and remember to run every day.

  4. Patients don’t live in a vacuum–we live in families. Focusing exclusively on patient behavior ignores the role that family and friends play in supporting or sabotaging healthy behaviors. A patient who becomes more active and chooses to eat healthier food may find those changes criticized by their spouse, family members or friends. Some spouses may feel threatened because they don’t like role changes, or they’re fearful that their other people will be attracted to their spouse, or they don’t want to see that change is possible. Eating healthier has a lot to do with who buys the food, who prepares the food, who serves the food–sometimes patients working on getting and staying healthy feel that their best efforts are being sabotaged by people who should be supporting them. Until you’ve experienced it first hand, or you ask patients about it directly, you can’t believe how much conflict can come out of a healthy lifestyle. Some patients just can’t keep fighting that battle.

  5. Very insightful article. Patient engagement is a question that many are thinking of now in the healthcare community. Kudos!







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