The 5 Ds that Make Patients Bad Partners in Healthcare

From the point view of patient's, an important focus of healthcare reform is to directly interact with their healthcare decisions. While this is a laudable goal, there are a number barriers need to be cleared in order to make it viable. Why most patients are not good partners when it comes to healthcare decisions for themselves or loved ones? I believe there are at least five reasons :

      Distress

  Patients come to a physician typically only after a disease or process has progressed to the point that it is no longer comfortable for them to ignore it. This distress, by itself, puts the patient at a disadvantage for making judgments and assessing importance.
 

  Denial

When faced with any significant issue, particularly one affecting health, most patients move relatively quickly through the phases of grief, from shock to denial. Feelings like, “it's not that bad,” or, “that doctor doesn't know what he's talking about,” are common. Denying the disease itself or the cause of the disease frequently leads to treating symptoms and not the illness.

  Dollar

  When presented with different options for therapy or diagnosis, cost is frequently never discussed. When it is, the more subjective idea of the "value" of each alternative is more difficult to convey. This is because physicians and other providers have spent years in school trying to get a handle on just that question.

  Data

  Patients, armed with the latest Google search present themselves to their provider with a complaint list and everything they "know" about their illness. Physicians can have difficulty sorting through what is true or reasonably true versus the latest ad, wrapped up as real information.
  Dose

  From the radiology standpoint, patients are being told that their diagnostic examination will lead to cancer — at least that's what many remember from the latest media blast. In ALARA terms, sometimes the highest dosage radiology examination( taken by a mobile x ray machine, c arm, digital x ray machine, etc), is the one has the biggest value. The exam with the least value and lowest cost offen has the lowest dose and sometimes it's a mixture of highest cost — lowest value or lowest cost moderate value.