3 ms·

> Well the research has shown [too lazy to come up with a citation for that] that it is very beneficial for patients to be well informed and involved in the the

> Well the research has shown [too lazy to come up with a citation for that] that it is very beneficial for patients to be well informed and involved in the therapy process That's an irrelevant point: You won't see me advocating against having the patients fully informed and making decisions, after being given "alternatives" and respective pros&cons by their physicians. But what I was discussing was the knee-jerk reaction to the "thinking for yourself is untenable" argument. > This works, because you don't have to an expert on athletes' foot to manage your diabetes well, you just have to be an "expert" of your own case. I would say it's very oblivious to think you're an expert on your case. It means your emotions are way too much present: the fact that something is terribly relevant to you doesn't imply that you're an "expert" in it. > And that, my friend, is the definition of individual free-thinker. Quite a strange definition. But OK: if that's a very important point for you to make, great. Just don't say that this is "thinking by yourself". You may have made the decision yourself, but the "thinking" part was on the physician all the time. He had the knowledge, he presented it to you, alongside the pros&cons, and he was there to warn you if you by chance made a wrong/worst decision.

arpa 11y ago
>I would say it's very oblivious to think you're an expert on your case. It means your emotions are way too much present: the fact that something is terribly relevant to you doesn't imply that you're an "expert" in it. I wouldn't discount emotions as being irrelevant for health. Patient involvement is very important in the empowerment process, and the patient is the expert in the ways that physician can never be: [s]he, not the physician, knows that drug A causes his/her skin itch; he, not the physician, cares for the quality of life, etc. And, sadly, you miss the point completely: experts have broad knowledge of the situation, while the "expert" patient knows (with the help of experts, of course, of course, of course) his exact case. And the "thinking" part is not done by physician all the time. Empowered patient does the majority of "thinking", the physician is there for support and information. Physician is the expert systems' knowledge base, while the empowered patient is the expert system doing the "thinking" and making informed/educated decisions. Edit: e.g. http://www.sciencedirect.com/science/article/pii/S0738399109003279 http://www.sciencedirect.com/science/article/pii/S0738399109... (emphasis mine) >Conclusion >Unlike the traditional approach, empowerment is not something one does to patients. Rather, empowerment begins when HCPs acknowledge that patient are in control of their daily diabetes care. >Empowerment occurs when the HCPs goal is to increase the capacity of patients to think critically and make autonomous, informed decisions. Empowerment also occurs when patients are actually making autonomous, informed decisions about their diabetes self-management. And this is not a new thing in heathcare either, there is a plethora of articles saying the same since 1994.
DanBC 11y ago
There's a strong push to get patients to be more involved in their own care and to make decisions about their health and to be experts in their own health condition. There are expert patient programmes http://www.nhs.uk/NHSEngland/AboutNHSservices/doctors/Pages/expert-patients-programme.aspx http://www.nhs.uk/NHSEngland/AboutNHSservices/doctors/Pages/... There are expert patiet groups. Patient choice is (in the UK) written into law and into Department of Health, and NHS, and Clinical Commisioning Groups, and Trust guidance documentation. You might want to learn what people mean when they talk about expert patients because it's not going away and you seem to have some misunderstanding about it. > Just don't say that this is "thinking by yourself". You may have made the decision yourself, but the "thinking" part was on the physician all the time. He had the knowledge, he presented it to you, alongside the pros&cons, and he was there to warn you if you by chance made a wrong/worst decision. This assumes that doctors are not subject to the same cognitive biases that patients are. But doctors clearly are subject to those same biases. The RCT for knee arthroscopy shows us that.
- paulojreis 11y ago
  I think your reply is generally misguided and straw man-like fallacious. I never advocated against having patients involved and making decisions (which I pointed explicitly above), nor said anything which justified you prompting me with something like "Patient choice is (in the UK) written into law" (where have I questioned that?). It seems you're replying to someone else, probably a straw man. > This assumes that doctors are not subject to the same cognitive biases that patients are. I really can't tell how could you reach such conclusion. I just said that the doctors are the ones which hold and present the knowledge, as well as supervise your decision. No mentions. at all, to "patients are biased; doctors are 100% objective". Again, what I was discussing was the knee-jerk reaction to the "thinking for yourself is untenable" argument.

arpa 11y ago

>I would say it's very oblivious to think you're an expert on your case. It means your emotions are way too much present: the fact that something is terribly relevant to you doesn't imply that you're an "expert" in it. I wouldn't discount emotions as being irrelevant for health. Patient involvement is very important in the empowerment process, and the patient is the expert in the ways that physician can never be: [s]he, not the physician, knows that drug A causes his/her skin itch; he, not the physician, cares for the quality of life, etc. And, sadly, you miss the point completely: experts have broad knowledge of the situation, while the "expert" patient knows (with the help of experts, of course, of course, of course) his exact case. And the "thinking" part is not done by physician all the time. Empowered patient does the majority of "thinking", the physician is there for support and information. Physician is the expert systems' knowledge base, while the empowered patient is the expert system doing the "thinking" and making informed/educated decisions. Edit: e.g. http://www.sciencedirect.com/science/article/pii/S0738399109003279 http://www.sciencedirect.com/science/article/pii/S0738399109... (emphasis mine) >Conclusion >Unlike the traditional approach, empowerment is not something one does to patients. Rather, empowerment begins when HCPs acknowledge that patient are in control of their daily diabetes care. >Empowerment occurs when the HCPs goal is to increase the capacity of patients to think critically and make autonomous, informed decisions. Empowerment also occurs when patients are actually making autonomous, informed decisions about their diabetes self-management. And this is not a new thing in heathcare either, there is a plethora of articles saying the same since 1994.

DanBC 11y ago

There's a strong push to get patients to be more involved in their own care and to make decisions about their health and to be experts in their own health condition. There are expert patient programmes http://www.nhs.uk/NHSEngland/AboutNHSservices/doctors/Pages/expert-patients-programme.aspx http://www.nhs.uk/NHSEngland/AboutNHSservices/doctors/Pages/... There are expert patiet groups. Patient choice is (in the UK) written into law and into Department of Health, and NHS, and Clinical Commisioning Groups, and Trust guidance documentation. You might want to learn what people mean when they talk about expert patients because it's not going away and you seem to have some misunderstanding about it. > Just don't say that this is "thinking by yourself". You may have made the decision yourself, but the "thinking" part was on the physician all the time. He had the knowledge, he presented it to you, alongside the pros&cons, and he was there to warn you if you by chance made a wrong/worst decision. This assumes that doctors are not subject to the same cognitive biases that patients are. But doctors clearly are subject to those same biases. The RCT for knee arthroscopy shows us that.

paulojreis 11y ago
I think your reply is generally misguided and straw man-like fallacious. I never advocated against having patients involved and making decisions (which I pointed explicitly above), nor said anything which justified you prompting me with something like "Patient choice is (in the UK) written into law" (where have I questioned that?). It seems you're replying to someone else, probably a straw man. > This assumes that doctors are not subject to the same cognitive biases that patients are. I really can't tell how could you reach such conclusion. I just said that the doctors are the ones which hold and present the knowledge, as well as supervise your decision. No mentions. at all, to "patients are biased; doctors are 100% objective". Again, what I was discussing was the knee-jerk reaction to the "thinking for yourself is untenable" argument.