Make your doctor an ally

“Patient empowerment is all about allowing someone with an illness or disability to live their life as normally as possible according to their own standards,” says Harry van de Wiel, professor of health psychology at the University Medical Center Groningen and specialized in medical communication. “In principle, every condition leads to a certain degree of limitation and dependence. But empowered patients resist. You take responsibility for your illness yourself and do not sit back and assume that the doctor will solve everything for you. You are assertive, builds up knowledge about your illness, you take your medicines properly, but you specifically whether or not you still want to be treated. In short, you are in control.”

directing

Empowered patients therefore make conscious choices. For example, one person wants to get rid of his pain at all costs and takes any side effects of a medicine for granted. For the other it is especially important that he can continue to function socially, if necessary with pain, but without side effects that could stand in the way of that functioning. The fact that patients can make such choices is very important in their functioning. Van de Wiel: “Research shows that these patients make less use of medical facilities, have less absenteeism due to illness and above all happier to be.”

According to the professor, patient empowerment is of course not something that comes into play when you come to the emergency room with a broken leg. Even if the diagnosis has not yet been made, it is not advisable to enter the doctor’s office with a folder full of printouts from the internet. That shows little confidence in and respect for the knowledge of the doctor. Van de Wiel: “Then let the doctor do his job. Patient empowerment applies to people who have to live with a chronic illness such as rheumatism, COPD, diabetes and cardiovascular disease.” Van de Wiel acknowledges that the empowerment process will be easier for some people than others: “That depends on factors such as cultural background, level of education and the nature of the animal. One is simply more assertive than the other.”

Recreate yourself

In his book The power of adversity English professor Stephen Joseph compares major setbacks, such as the diagnosis of a disease, with a vase that has fallen into small pieces. People who try to put their life together exactly as it was, remain vulnerable. Just like the vase that was put back together with glue. But those who accept the damage and rebuild themselves in a different way become resilient. In other words, you can also turn the shards into a beautiful mosaic.

Van de Wiel agrees that the path to empowerment starts with acceptance: “It can be very difficult to process an emotional shock, such as the diagnosis of rheumatism. Life is suddenly no longer perfect. You often see that people who do not take their medicines properly in fact resist the acceptance of their illness.For that acceptance it is nice if you can tell your story to family and friends or through contact with fellow sufferers.Some people benefit from a conversation with a psychologist or social worker.

After acceptance comes the phase in which you build up knowledge about your disease. You must become an expert in your condition, for example by asking questions to the doctor, looking for information on the Internet or talking to fellow sufferers. What choices are there when it comes to medicines? What about side effects? How often should I take them? Which hospital is best for me? You then list what the disease means to you, what problems you encounter, what you want to do with your life.” Only when you know enough can you make the mosaic with the shards, you can get started with it. picking up your life.

Patient and doctor as treatment team

Van de Wiel notes that some care providers still have difficulty with self-reliant patients: “On the one hand, they endorse patient empowerment. Self-reliance is part of this time and our culture, it is better for the patient and it saves society money. On the other hand they would like to help patients themselves, because a care provider is happy to provide help. In addition, care is also just ‘a shop’. If you are busy, it is good.”

An important consequence for healthcare providers is that their approach to the patient has to change. A patient who wants to make his own choices benefits more from a coaching doctor than from a doctor who solves the problems for the patient. Van de Wiel: “For example, if a doctor thinks it is sensible for a patient to exercise, then he should let him think about it for himself. Do you want to exercise more? How are you going to do that?” In fact, as a patient, you and your doctor form the treatment team that works towards a common goal. This requires mutual trust, says van de Wiel: “The patient can only take responsibility if the doctor gives confidence. If he continues to behave as a schoolmaster, he will not succeed. On the other hand, a doctor can only give a patient confidence if he sees that he is willing to take responsibility.”

It has to click

The relationship between doctor and patient can come under pressure if the disease cannot be brought under control, says Van de Wiel: “The patient expects the doctor to ‘adjust the motor’. But if he does not take his medication properly or does not follow the lifestyle advice If you do not follow this up, you will not succeed. In fact, the specialist should not treat the disease, but the patient and there is often no time for that. Fortunately, there are also specialized nurses, such as rheumatism consultants and COPD nurses, who have more time to focus on the person behind the disease and can give the patient tips to get the disease under better control.”

The doctor-patient relationship also has a major impact on the success of a treatment. Van de Wiel is currently investigating with a number of rheumatologists why there is a click between patient and doctor. This so-called ‘click factor’ even appears to influence therapy compliance, ie whether a patient is taking his medication correctly. “If it doesn’t click, it is really wise to find another doctor,” says Van de Wiel.