How to be a patient

Patient centricity is an idea that has moved from the periphery to centre stage in pharma marketing. It is aligned with the NHS principle of shared decision making ("No decision about me without me"), which views patients as stakeholders in their own health instead of passive bystanders.  
While we have been debating about the role of patients in their transactions with the health service, the face-to-face relationship between patients and doctors has been undergoing a transformation. Long gone is the patriarchal attitude of the medical profession and the deference of patients towards doctors. Patients have evolved from grateful healthcare recipients who assume that doctor knows best, to agitators demanding the best medical care that the limited NHS budget can deliver.  
Doctors confirm that the balance of power has shifted decisively. When we talk to GPs, many say they feel embattled and even bullied by what used to be categorised as 'heartsink' or problem patients. The patient population has ramped up its expectations, armed with Google search results and a list of demands. Patient associations and advocacy groups have become more vocal and influential, and health is one of the most discussed topics on social media.  
There are signs, however, that a 'third wave' is now emerging, where patients and doctors meet half way as partners in healthcare. This has been driven by a rise in general health literacy, aided in part by the internet. It is also tempered by realism: patients know that the NHS is under-resourced and government promises are unaffordable. They realise there is not a pill for every ill, so they don't demand an antibiotic for every infection or expect to walk out with a prescription after every consultation. Most patients also accept that in chronic conditions, they are expected to take some responsibility for managing their own lifestyle and risk factors, even if they don't embrace it.  
The latest edition of Which - the magazine for consumers - is diagnostic of the new attitude. In a feature titled "Help your GP to help you", the magazine offers instructions to patients on how they should behave to get the most out of a consultation. Based on interviews with 15 GPs trained in the ICE methodology (eliciting patients' ideas, concerns and expectations), it advises people how to prepare for the 10-minute slot they are likely to get with their doctor.  
Key recommendations include:

• Get to the point - avoid vague descriptions and irrelevant detail
• Dress for action - wear loose clothes so you can get your kit off quickly
• Know your notes - everyone should be their own health information manager (92% of practices across England provide health records online)
• Doctors are fallible, underfunded and overstretched - treat them accordingly

The guide provides a translation of common questions used by GPs, in a neat reversal of the training offered to GPs to interpret patient-speak. It lists trusted health websites that GPs recommend to their patients. It even warns patients to avoid the 'doorknob syndrome' dreaded by GPs ("One more thing before I go..."). Finally it says patients should not regard the receptionist as a guard dog, but a bloodhound to help them track down the person most skilled to help.  
Of course, not every patient has access to Which, and those who do are probably more proactive and better informed than the general public. But in recent years, the general patient population has changed from ill informed to relatively health savvy individuals.  
Most pharma companies now have patient engagement departments and senior people dedicated to seeing the patient's perspective. But because of restrictions relating to POMs, our industry faces difficulties in talking to the end user about the products they consume. We can listen into social media conversations, but many companies are wary about actively participating due to pharmacovigilance issues.  
So how can we help the new generation of health consumers?  
We can design clinical trials with outcomes that matter to patients, and promote medicines to HCPs using messages that are important to the end user. We can also produce apps, instructions on optimising treatment and devices to support adherence.  
Like many agencies, we have been monitoring patient needs through involvement in CCG patient engagement initiatives and practice-based Patient Participation Groups. We have learned that patients have many sources of health information, but lack the knowledge to discriminate between good, evidence-based advice and the fake news peddled by vested interests sheltering under the banner of alternative medicine.  
What patients want most is unbiased education to support informed decision making. We can therefore provide a service by offering impartial, code-compliant information as an antidote to the 'alt-med' lobby.  
Now that we have identified the patient as the centre of our universe, pharma companies no longer need to be satellites, orbiting them but unable to make contact. By ensuring our communications are based around patients' needs, concerns and expectations, we can help to restore their trust in the industry, and rebuild trust with HCPs.  

© 2017 Life Healthcare Communications  

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