Angelina Jolie’s highly publicized decision to undergo a preventive double mastectomy has highlighted the increasing role that patients play in clinical treatment decision-making. The number of women requesting genetic testing for BRCA1 and BRCA2 mutations will likely continue to increase with the recent Supreme Court decision involving naturally occurring DNA extracted from the human body. Direct-to-consumer advertising has resulted in patient-to-physician conversations that are often prefaced with “Doctor, I saw an ad on TV for a new medication for the condition I have. Can you prescribe me that instead of what I’m currently taking?”
With today’s unparalleled access to information, patients are taking a more active role in researching their health conditions—and coming to their physicians not only with questions, but also treatment recommendations to discuss. What is the appropriate role for patients relative to treatment decision-making? How does this affect the way physicians make decisions and counsel their patients? As accredited providers, what are the implications for continuing medical education?
Developing Patient Resources
As patients become more educated about acute and chronic conditions, they need to have access to scientifically validated treatment and disease-management information. While it is beneficial to incorporate these resources into a comprehensive CME initiative, physicians have to know how to implement them when it comes to their patients. Patients may have a hard time understanding why they’re not good candidates for a specific medication they researched, and the patient-counseling aspect of care can also be overwhelming for busy physicians whose large caseloads limit the time they can spend with each patient.
Providers might consider including presentations in their CME activities about how to optimize patient counseling to help alleviate challenges on both sides. Additionally, even when providing non-CME-certified resources that don’t require it, providers should conduct follow-up research to evaluate the effectiveness of including these resources on physician confidence, behavior, and ultimately, on patient health improvement.
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Now that the Affordable Care Act is the law, pharmacists, physician assistants, nurses, and nurse practitioners are playing an increasingly active role in primary care to provide treatment for the estimated 32 million additional Americans who now have access to healthcare. These allied health professionals, who are on the front lines of treatment alongside physicians, add value by being able to advise patients regarding medication side effects, drug interactions, and treatment adherence.
When planning and developing comprehensive continuing education initiatives, providers should consider:
• What allied health professionals will play a role in the clinical decision-making process?
• When will they be involved within the treatment continuum?
• How do they communicate and collaborate most effectively with physicians?
• Are they (or the physician) in the best position to provide in-depth patient education?
Once you know the answers, you can tailor your CE initiatives based on the entire care spectrum.
The Benefits of Collaboration
Providers, like the clinicians we help educate, are being tasked with doing more with fewer resources. Collaborating with other CME/CE providers can help ease those burdens, especially when providing interprofessional education or patient-centered resources. Educational partners can help provide expert to speak to the needs of pharmacists, nurses, and other allied health professionals. They also might have partnerships with patient advocacy groups or established patient education resources that could be included as part of a comprehensive initiative.
Education, Collaboration, and Empowerment
Healthcare reform, coupled with an increasingly empowered patient population, is poised to create a paradigm shift. As CME/CE providers, we can collaborate with each other to create innovative CE activities that effectively respect the expertise of the clinicians we educate and integrate the viewpoints of the patients they serve.
Ann C. Lichti, CCMEP, is the director of accreditation and compliance for Physicians’ Education Resource®, LLC (PER). Reach her at firstname.lastname@example.org. The opinions expressed are those of the author and do not constitute the views of PER.