‘Good morning Mr. Smith. Good to see you, how are you doing? You’re looking for a new car? That’s good news. We decided that it’s going to be a Ford Focus, ST, 2.0 Eco-boost, 184 KW, 6-gear. Let’s see in stock if there is a possibility that you decide on the color otherwise it will be a red one.’

Does this conversation look strange to you? I hope so. But this is reality in health care for patients every day. In health care patients got absolutely nothing to say or at least nothing to decide. Yes they are allowed to sit in an advisory board and yes they are every now and then tolerated in discussions with the board but when it comes to make a decision in healthcare the door is closed and the patient has to wait for the decision.

I am not talking about shared decision making when it comes to the right treatment for this individual patient at this moment. I want to believe that develops in a good direction. It can be improved and has to speed up but it’s good to see that this is getting somewhere. I’m talking about quality of care and the way care is organized. How do you manage a hospital? What concentration of care (looking at cardiovascular and neurologic diseases or cancer) has the best quality for patients and will lower the cost of healthcare dramatically? Why are there a clinician and a financial expert in the board of a hospital and not a patient advocate? We’re not stupid. We know how to organize health care because we have a lot of experience and knowledge because we work in health care or at least are for many years involved in health care and work as managers in other fields of expertise. We are left outside and I think for a reason.

Patients do not want to be patients and if they are patients they want as soon as possible be patients no longer. And with a health care system that benefits from as much patients as possible it’s obvious that we have to stay out of the decision making process as long as possible. We patient advocates know that health care benefits from keeping us as long as possible a patient. This is not meant to be but it is how the system has evolved. And when treatments mean invoices and income we don’t want the patients of the system. I’m convinced that this is not bad intention but I am sure that without patient advocates being part of the decision making process this won’t stop.

If about us, not without us. Health care exists because we patients exist and therefore we should not only be asked about what we want, we should also decide about all matters in healthcare. Simply for the sake of the patients and their loved ones and for the sake of lower costs in health care. I’m convinced and did research on this and putting patient advocates in the right position will lower the cost of health care extremely.

Is this what we want? I think it is but it depends on your position in het Medical Industrial Industry whether you work on this as a solution. Because we all have our dependencies: our income, family, manager, company and so on. But from my own experience I know that when you put all the stakeholders around the table and ask for their real interests we can work on a solution that fits us all. It’s about the win-win and not about compromises. Working on a compromise means that we are not working on the best quality of life for patients and their loved ones. And health care is about the latter.


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