Jordan Dolin, Co-Founder, Emmi Solutions
(as published in the Chicago Tribune on November 15, 2009)
By Jordan Dolin
A few months ago, I sat with my mother in the emergency room as she recovered from a minor heart attack. The cardiologist entered the room and told her she needed an angioplasty immediately. My mother was clearly scared. She asked what she needed to know, but the doctor dismissed her by saying, “Honey, all you need to worry about is if I am going to listen to opera or Steely Dan during the procedure.”
Comments aside, it’s what the cardiologist didn’t say that was most troubling. He didn’t explain why my mother needed the procedure. He didn’t discuss why her case was different from those of the more than 500,000 patients who have unnecessary angioplasties in the U.S. every year – a number that according to the New England Journal of Medicine represents more than 40 percent of all such procedures. The cardiologist didn’t mention the procedure’s risks or even its benefits.
I am not a doctor. I cannot tell you the procedure was or was not needed. But I know that my mother usually opts…I am not a doctor. I cannot tell you the procedure was or was not needed. But I know that my mother usually opts not to have Novocain when having dental work, and she may well have chosen to avoid the $16,000 procedure if she’d known options broader than opera or Steely Dan.
Much of the recent debate in Washington has been over insurance reform. Essentially, the two parties are arguing over who has to pay for my mother’s angioplasty. While this discussion is important and long overdue, it misses a great number of the problems facing America’s health care system. It doesn’t address why doctors – like my mother’s cardiologist – would prescribe so many unnecessary procedures, tests and even medications when the risk of complications is ever present and often lethal. And it doesn’t address why our population consumes so much health care without getting any healthier.
There is no silver bullet and true reform will have to include a variety of solutions. But the current debate ignores a tremendous untapped resource that is free and actually wants to contribute: patients. As patients, we have the most at stake in the equation. We want to be involved in our care and we need to be involved if improved insurance, care coordination and access are going to translate into improved health.
There is a lot of talk and even more money headed toward improving the connectivity of our caregivers. For these investments to succeed, we need to place a similar effort into improving the connections between caregivers and patients. Armed with proper information and skills, patients are more engaged in their care and better able to achieve their health goals whether that’s controlling their diabetes or, like my mother, avoiding another heart attack.
Studies show engaged patients consume fewer health care resources while experiencing better clinical outcomes (health). Doesn’t that sound like an essential goal of reform? Recently, Sen. Richard Durbin, D-Ill., visited the company I helped co-found. Our time was brief, so we had to make our message simple. Health care reform cannot ignore and infantilize patients the way my mother’s cardiologist did. If health care reform is going to pay off, we need to put the patient at the center of care, and give her the information and tools she needs to make herself healthier. Otherwise, the choice of private versus public option will amount to little more than opera or Steely Dan.
Jordan Dolin is co-founder of Chicago-based Emmi Solutions, which creates Web-based interactive patient education programs.
