By Trudy Lieberman

Recently I heard from a woman in rural Nebraska who told me about her 76-year old father, who in late April had a lemon-size cancerous mass removed from his brain. The man chose to have his chemotherapy and radiation treatments at a hospital close to his home instead of at one of the larger hospitals farther away. Not surprisingly he wanted family nearby.

Often patient engagement has come to mean selling things, particularly tools and devices, that purport to help patients manage their care.

During the man’s many calls with the supplier the company tried to sell him knee and back braces, advising that Medicare would pay if he got a doctor’s prescription.

Last year I was invited to attend a panel discussion about innovations in patient engagement.  The room was full of young marketers eager to sell their products and share the best ways to reach patients.

vSince the term patient engagement is so slippery, it wasn’t surprising the program began with a discussion of what it actually meant. 

One panelist offered this definition: “It really has to do with how can you get patients to do more or become more active in the ecosystem about their health.” Another said, “Let’s think of patient engagement as a marketplace.

How are they engaged in the marketplace? 

Perhaps he meant that people like the man who needed an insulin pen pronto would be “engaged” enough to buy a brace he did not need.

Another panelist noted, “People’s engagement with health is quite low. There’s a gap we’re seeing between technology and tools and the patients and doctors involved in using them.”  A fellow panelist said patients “don’t want just excellent care. They want an experience.”

Most experts would argue that patients too often are not getting excellent care. Postponing medical treatment because of schedulers’ errors and nearly running out of insulin because a company’s procedures are inefficient hardly qualify as excellent care.  “Experiences” like those are all too common.

That’s not to say patients shouldn’t be active in their care. Growing evidence suggests that patients who are more actively involved have better health outcomes.

But that doesn’t mean profit-seeking providers should be pushing unnecessary care, pills, or devices onto patients.

I recently got a letter called a Care Consideration from Aetna, my supplemental insurer. It said, “This information was identified to support you in working with your doctor to improve your health.” The letter was a not-so-subtle push to take a statin for heart disease.  There was just one problem. At my last physical less than a year ago my cholesterol was “excellent,” as it always has been. No medication required. 

Pushing a drug and trying to overrule my doctor does not qualify as patient engagement.

What does patient engagement mean to you?  Write to Trudy at trudy.lieberman@gmail.com.