Model of Patient Participation in Healthcare Policy

1. Towards an Empowered Patient Myths and Realities Durhane Wong-Rieger, PhD Consumer Advocare Network

3. Levels of Individual Empowerment 18 October 2002 Patient Knowledge Patient Decision Making Patient Demands “ What Patient Wants, Patient Gets” Driver: Desires, values, beliefs Patient role: Push for what is wanted and needed Relationship: Distrust, negotiation Responsibility: Physician/Patient Success Factor: Acquiescence Paternalistic “ Doctor Knows Best” Driver: Doctor decision Patient role: Comply with decision and prescribed treatment Relationship: Unequal; compliance Responsibility: Physician Success Factor: Trust Informed Choice “ Patient has Final Word” Driver: Patient Choice Patient role: Assume responsibility for own care; choose Relationship: Equal, challenging Responsibility: Patient Success Factor: Mutual respect Informed Consent “ What do you think about…?” Driver: Doctor choice Patient role: Seek information; get recommendation; consent Relationship: Unequal; challenging Responsibility: Physician/Patient Success Factor: Patient Input

5. Levels of Consumer Engagement 18 October 2002 Community Representation Role in Decision Making Advisory Purpose: Gain advice, test product Input: Task forces, advisory groups, designated positions Information: Privileged, selective Membership: Appointed Representation: Limited Accountability: Decision body Individual Information Purpose: Provide/Gather Information Input: Poll, surveys, focus groups, town hall, ombudsman Information: General, public Membership: None Representation: None Accountability: None Partner Purpose: Public Commitment Input: Boards, councils, consensus conferences Information: Public, privileged Membership: Nominated, expert Representation: Group, public Accountability: Public, group Consultation Purpose: Discuss/Form Opinion Input: Meetings, commissions, Internet Information: Specialized, solicited Membership: Solicited Representation: Interest, Community Accountability: None, group Individual Community Low High

6. M 18 October 2002