In order to give patients patients a more active role in health care, neurologist Bas Bloem at the University Medical Center St. Radboud and professor hoogleraar Neurological Movement Disorders at the Radboud University in Nijmegen, makes use of internet an social media. These media allow for easy contacts between medical and nursing staff, patients and researchers, which improves the quality and reduces the costs of health care. Especially patients with a chronicle disease know at least as much about their disorder and often more than a doctor. They are very well equipped to advise other patients on how to live their daily lives with a disorder.
A patient who is more involved challenges medical staff to take up a different role. Bas Bloem sees a doctor mostly as a coach: someone who provides good information, so that patients can make an informed decision. An example of the doctor as coach, who actively involves patients in their treatment, is the concept of group appointments, which has been developed by the Center for Heart and Vascular Diseases at the University of Virginia. Where traditional cardiologists usually assign half an hour for a consult with a patient, here the patients have the choice between a one-on-one appointment or a group appointment of an hour and a half, in which the cardiologist speaks with a group of sometimes ten patients at a time. Patients who choose for a group appointment gather in a meeting room, where they fill out the necessary forms and talk with each other until the doctor has had time to physically examine each of the patients. During the collaborative consult the cardiologist gives information and advice, discusses medication and progress of the patients and the next steps in treatment for each of them.
Group appointments evidently increase a hospital’s productivity but patients too seem to prefer a group appointment (98 % satisfaction after the fist experiments). They don’t need to wait, they can often make an appointment for the next week, they learn from the advice the doctor gives to other patients and they learn from each other about life style and emotional aspects of their disease. They experience a stronger connection with their cardiologist and have more respect for him or her, because they see then doctor at work with other patients. This approach has recently been expanded to obesity patients and the first experiments show that they loose more weight than with a traditional appointment.
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