This Fall, a close friend of mine was diagnosed with breast cancer, underwent surgery, and began radiation treatments. While the physical aspects of dealing with such a serious illness are, obviously, a tremendous ordeal, my friend has also been devastated by what she calls the diminishment of her personal dignity.

During one visit, a male technician snapped a digital photo of her breasts, then a photo of her face as she held up her chart. She didn't know in advance about the digital photography — it just happened. No warning. No explanation. She had no chance, she says, to reflect or react. Afterward, when she asked about it, her doctor gave her several conflicting explanations, one of which was that the Joint Commission on Accreditation of Healthcare Organizations requires two forms of patient identification, and one of those has to be a photo. (As I understand the JCAHO rules, a photo is not mandatory. Further, I think we need to develop effective patient safety measures that don't invade a patient's privacy and exacerbate her sense of vulnerability. But that's another article.) My friend was frustrated because her physician kept changing the story — but what also upset her was that her doctor never said: I understand your concern.

While CME providers aren't responsible for developing patient safety procedures and JCAHO rules, they can take initiative in training healthcare practitioners how to treat patients with respect while enforcing those requirements and how to listen and respond to patients' concerns. As you all know, the goal of the new Accreditation Council for CME criteria is to strengthen CME's role in improving healthcare quality and patient safety. CME providers, especially those aiming for Level 3 (accreditation with commendation) are encouraged to use noneducation strategies — including patient satisfaction questionnaires — to help motivate physician behavior change.

The push for CME providers to take a more active role in the wider healthcare system offers a great opportunity to bring the patient's point of view into CME. How about including patients in the CME needs assessment and planning process? Ask for their input on how healthcare practitioners can improve the quality of care. Something that might seem trivial to physicians, or not even be on their radar screens, such as my friend's experience with digital photos, might be of vital importance to patients. Give patients the chance to speak at conferences and offer their insights into how paying attention to patients' dignity and enhancing practitioner communication skills can foster patient compliance. By participating in CME, patients can act as a powerful force for driving change in physician behavior.

In the January/February issue, MM columnists Ann Lichti and Nathalie Harden will explore their ideas for bringing patient advocacy groups and other stakeholders into the CME enterprise. I'd love to hear about your experiences creating patient-driven CME and your thoughts about how those initiatives might fit into the ACCME's new criteria and goal of elevating CME's role in the broader healthcare community.

Patient care is about more than the life-and-death issues of improving patient outcomes and preventing medical errors. It's about empowering patients to participate in shaping their own treatment and the future of healthcare. All my friend wanted, she said to me, was “a modicum of respect.” That shouldn't be too much to ask for.
Tamar Hosansky