In the News

As published in the AAMC Newsletter, August, 2006.

Patients Become Partners: School Educates Public in Health Care

By Scott Harris

When Michael Shonta’s 83-year-old mother suffered a stroke, he did not know where to turn.

“She had been sick for a while, and I was so baffled about her care,” Shonta said.

Lying weakened in a hospital bed, Shonta’s mother turned down an MRI exam, fearing the confines of the MRI chamber.

“I looked at her chart and saw where they marked the MRI as her having refused it,” Shonta said. “I told the nurses that I had power of attorney as her guardian, and they couldn’t simply take the word of an 83-yearold recent stroke victim without consulting me. I knew I could order the test, and I did.”

The exam revealed her carotid artery to be 60 percent blocked—less than anticipated—and prevented an unnecessary operation.

Sharon Madsen has sinusitis that often causes severe headaches. In search of relief, her physician recommended a routine CAT scan. Madsen’s reaction, however, was anything but routine.

“I told him we had already done a CAT scan, and I told him what the tests had showed,” she said. “I asked him, since we already had that data, what was another benefit to the CAT.

“You have to become a partner in your own care.”

Shonta and Madsen credit their newfound confidence to Patient School. Created by the University of Connecticut (UConn) Health Center, Patient School is a new, classroom-based program that offers members of the general public a baseline of knowledge for successfully negotiating the nation’s increasingly complex health care system.

“I’ve treated a lot of folks over the years, and the way I’ve been most successful is if patients understand what they have and what their responsibilities are,” said Robert Trestman, M.D., Ph.D., director of the Patient School, the Connecticut Health Signature Program, and the Center for Correctional Mental Health Science Research at UConn Health Center. “One of the failings we’ve had is to not have patients understand their own conditions. This is a wonderful opportunity to shape that."

“Health care has become very, very complicated, and it’s only going to get worse,” Trestman continued. “For people to be successful, they have to have a knowledge base that goes beyond understanding just one specific illness.”

For five weeks this March, 30 Patient School students met for two hours each Wednesday and received formal training from UConn Health Center faculty on topics including patients’ rights, basic medical protocols and procedures, end-of-life issues, and methods of checking physician or hospital credentials. A second Patient School session is scheduled for September.

James Walter, associate vice president, communications for UConn Health Center, conceived the idea as the center drew up its annual marketing plan.

“We always like to include something that’s a little bit different,” Walter said. “The concept of a patient school was preceded by the notion of patient empowerment. There’s an important trend nowadays where patients are looking for different kinds of information. They want to know how to navigate the system. Patient School takes that to another level.”

Madsen, who works as a medical administrator but had no significant medical knowledge prior to Patient School, called it an “eye-opening” experience.

“First hearing about the class prompted me to think about all those conversations I’ve had with doctors, where you’re just out in left field,” Madsen said. “When you go to the doctor and all you have is that 15-minute time slot, you want to get the most out of it as possible, for both sides. Because of Patient School, I’m now able to do that. Not only did we learn about different tests, but we learned about the strengths and weaknesses of those tests. It’s fascinating to see how physicians come to their recommendations. Now in the real world, you have a scenario in your mind that you can play against. You want to be able to understand everything that’s being said and what’s going on, and advocate if need be.”

“These classes allowed me to act with confidence when my mother needed me,” Shonta said.

Program officials claimed Patient School is the only program of its kind in the nation.

“Much to our surprise, no one else was offering a formal educational setting for patients,” Walter said. “What better place for something like this than an academic center?”

Trestman said the first session received “remarkable” feedback from both the students and participating faculty. He said 27 of 30 students attended classes consistently, and the faculty members who were involved expressed a willingness to participate again.

As for the future, program coordinators are “trying to determine the best way to scale this up,” Walter said. Trestman said the school could create a DVD or work with insurers or umbrella organizations to make the program more widespread and accessible, adding that the school had no “proprietary interest” in the program and hopes to share it with other schools and centers.

“It would help improve quality of care substantially if people began to assume appropriate responsibilities,” Trestman said. “We can’t afford as a nation to keep doing what we’re doing in terms of health care. We have to come up with strategies to push toward prevention. This would be one of the ways to do so.”