Teach the Conductor to Conduct

Although the word doctor is derived from the Latin word docere, meaning "to teach," many HCPs have not been thoroughly trained on the cornerstones of effective education. Do HCPs effectively teach their patients using patient education theory, reinforcing key messages throughout the continuum of care? Do they use the "teach-back" method to ensure that the patient has thoroughly understood the treatment plan, for instance? Do HCPs take health literacy into account, which goes far beyond reading level, translating key points into a language the patient can understand? The issue is that the training that most HCPs receive is focused more on the science and art of medicine and less on the patient profile, personalized healthcare, and patient engagement. These emerging facets in healthcare should be embedded into the medical education culture.

In alignment with the concept of lifelong learning, patient-centered education must occur across the medical education continuum—commencing in medical school, continuing throughout residency and fellowships, and reinforced through continuing medical education (CME).

Listen to the Patient

Patients are a powerful diagnostic tool that should be leveraged to understand preferences and circumstances to allow for personalization of the treatment pathway. A baseline assessment allows for the whole complex patient to be accounted for and concerns and expectations to be understood. The patient profile may include past experiences, beliefs, cultures, fears, psychosocial issues, comorbidities, and perception of values and quality of life that may affect levels of engagement and/or success with a treatment pathway.

Collaborative Decision Making

Research has shown that shared understanding, which enables patients to actively participate in their care (such as involvement in treatment choices) can lead to improved outcomes, without incurring an increase in healthcare costs. In the collaborative decision-making model, a convergence of both medical and non-medical issues occurs based on the exchange of information between the HCP and the patient, encouraging shared learning.

In this bidirectional process, the patient's role is to communicate informed values and needs shaped by their experiences and preferences. The HCP shares medical expertise, which include diagnosis, treatment options, risks/benefits, and probabilities of outcomes. Using the patient's profile as a compass, the HCP may reassess treatment plans, provide tailored decision support (aids, coaching), and arm the patient with problem-solving strategies. This partnership allows for coordinated goal-setting and an optimal course of action to be devised with continuous assessment built in to allow for modification, as necessary.

As the patient profile is taken into account, medicine transcends beyond a "one-size-fits-all" model. Concordance with guidelines and performance measures are important in healthcare; however, they often ignore patient preferences and their perception of value and quality of life. Patient-centered outcomes are important in this equation. Again, this is where the concept of a successful partnership is important: Process measures shaped by patient preferences to allow for patient-centered outcomes are crucial in ensuring healthcare is personalized and accounts for individual needs and decisions. The importance of the patient profile, power of the collaborative decision-making model, and the impact of tailored strategies on improving patient outcomes should be understood and integrated into practice.

Final Cadence

A transformation of the healthcare landscape is under way, as patients that were once "invisible" in healthcare play a more active role, truly acting as catalysts to change. There is interdependency between the science and art of medicine, the patient's personal profile and preferences, and the empowered patient's role in healthcare, but they have not been well integrated into practice. As a pharmaceutical sector, we can act as a strategic partner in healthcare by helping to bridge the gap between the revolution of the patient and medical education and increasing the focus on patient-centeredness in both patient and HCP education. Disease state education needs to be supplemented with the support of key theories such as collaborative decision-making and patient education theory. These concepts need to be interwoven into the thread of medical education, while addressing potential barriers to adoption. The transition into this model will take time to translate widely into practice, yet as the patient fine tunes their skill set in reaction to the HCP's ability to shape the composition, a seamless relationship will ultimately result in a harmonious performance. After all, what is the sound of a symphony where only the conductor can read the score? And where is the beauty of the soloist if they are never heard?

Sarah Krüg is Global Education Director, Medical Education Group at Pfizer. She can be reached at sarah.krüg@pfizer.com

All ideas/opinions expressed are the author's own and do not represent those of her employer, Pfizer Inc.