Patients Must Take Part in Their Own Health

This is so true for stroke survivors. Your doctor has absolutely no clue how to get you 100% recovered. Don't believe me? Flat out ask her/him. You won't like what you hear and don't hear.
We are totally on our own as Dr. Steven Wolf writes, a rehabilitation stroke expert and professor at Emory University School of Medicine in Atlanta.  "Stroke patients need to rely more on their own problem solving to regain mobility".
My obscene take on stroke survivorship:
If you just had a stroke, You are F*cking screwed  

Patients Must Take Part in Their Own Health
This week, we take a look at a new recommendation from the ACC/AHA-led Task Force on Performance Measures that suggests patients should share in the responsibility for their own outcomes. We spoke to a diverse group of healthcare professionals and asked:
"What do you think of the idea of patients sharing responsibility for their own outcomes, and what impact will this have on the doctor/patient relationship?"
The participants this week are:
Laura Burke, MD, MPH, attending emergency medicine physician at Beth Israel Deaconess Medical Center in Boston
David F. Penson, MD, MPH, Hamilton and Howd Chair, urologic oncology, professor of urologic surgery, medicine and health policy, director, Center for Surgical Quality and Outcomes Research at Vanderbilt University Medical Center in Nashville
Roy Buchinsky, MD, Director of Wellness, University Hospitals Case Medical Center in Cleveland
Helping Patients Help Themselves
Laura Burke, MD, MPH: "Even the best clinician cannot improve outcomes for those with chronic conditions without the effort of the patients themselves. A shared-accountability performance metric would help formalize this process and acknowledge the critical role that the patient serves in the care team. Some clinicians are excellent at connecting with patients and fostering the mutual respect necessary for adherence to complex treatments. They should be rewarded for their talent and efforts that so clearly benefit those that they serve. "
David F. Penson, MD, MPH: "The fact of the matter is that patients -- and other stakeholders for that matter -- play an important role in determining outcomes that physicians often have no control over. To this end, it makes sense to hold patients accountable as well. One would expect patients to want to do whatever possible to improve their health and get the best outcomes for themselves."
Roy Buchinsky, MD: "The patient needs to be an active and proactive member of the team in order to have maximum benefit. The more active a patient is in their own healthcare, the more likely a more favorable relationship will ensue by improving communications, efficiencies, and, ultimately, clinical outcomes."
Potential Drawbacks
Penson: "One has to worry that this might create a 'finger-pointing' situation where the doctor blames the patient for a bad result and the patient blames the doctor. One could envision situations where physicians "fire" patients from their practices because the patient was noncompliant or did not follow the physician's recommendations in the proper manner."
Burke: "Care must be taken to monitor for unintended consequences, such as disproportionate benefits to those who already enjoy advantages (e.g., wealth, education) that make it easier to adhere to treatment regimens and maintain health."
An Opportunity for Innovation
Buchinsky: "The No. 1 goal of the doctor/patient relationship is improving health outcomes. In an era of marked healthcare transformation, the team approach to health and healing is becoming more popular as is evidenced by the patient-centered medical home models. The advent of smart phones and digital technology has helped doctors stay in touch with their patients remotely, which further enhances the doctor/patient relationship."
Burke: "A well-designed performance metric that incorporates clinician-patient shared accountability could absolutely go a long way in empowering patients to engage as active participants in their care. Such a metric could help bridge the goals of evidence-based and patient-centered medicine, which are often perceived as contradictory. If designed well, a shared performance metric could strengthen the clinician/patient relationship by rewarding innovative practices that promote communication and patient engagement."