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This blind spot in medicine could cause some patients to give up on care


 Patients face challenges in managing their own healthcare in a fragmented healthcare system, and the burden of dealing with the many disparate parts, such as physicians, insurers and pharmacies, can cause some patients to stop seeking care, according to Vox.

From waiting on hold to speak with a physician on the phone to ferrying medical records between providers, the U.S. medical system requires patients to invest time in managing their care. This is collectively referred to as patient work.

“There is significant work involved in being a patient,” Victor Montori, MD, told Vox. Dr. Montori is a physician at Rochester, Minn.-based Mayo Clinic whose research focuses on the work healthcare assigns to patients. He has a term for the work that patients put into managing their care: the “healthcare footprint.”

Dr. Montori told Vox that patient work is a “major blind spot of medicine.” There’s no medical school class or textbook that helps physicians and nurses understand the work involved in being a patient, according to Dr. Montori.

One risk of ignoring patient work is that some patients will altogether stop managing their care. Those with inflexible work schedules often have to take time away from their job that pays to do patient work. For lower-income patients who often work for hourly wages and have little space to change their schedules, “prescribing healthcare with a high patient work burden can be equivalent to denying healthcare,” according to Vox.

To help address this issue, Dr. Montori is about to begin a pilot program that centers on the philosophy of minimally disruptive medicine. “The idea is that we, as clinicians and engineers, need to become obsessed with how we provide the best outcomes for patients while having the smallest possible footprints on their lives,” he told Vox.