Face it.  We all have personal health goals.  We may not share our personal health goals with family of friends like we do our financial or professional goals, but we all still have them.   I for example aspire to the following personal health goals:

  • To defy the conventional wisdom associated with aging (look younger, feel younger, live like I am younger).
  • To avoid premature aging – vision problems, flexibility and balance issues, aging and appearance, weight gain, skin tone, etc.
  • To not be called old by my grand kids
  • To live a more active life than my parents did
  • Question authority (yes I am a product of the 60’s and 70’s)

OK personal health goalsso I am vain.  I bet I am not the only one.  I am just the one dumb enough to publicly admit it (LOL).

Have I ever share these goals with my doctor?  Are you kidding me?

He can’t deal with the fact that I experience depression from time to time and insist on telling him about it…eeewww.   Besides…he will just tell me that getting old is part of the natural process.   You are supposed to lose your hearing, lose your balance and flexibility, get fat and wrinkly, become senile, and so on.   Let’s face it. It’s hard to have a conversation with someone – including your physician – when you know from experience that they are simply not interested in what you have to say when it comes to certain subjects.

There’s also another reason I have never shared my person health goals with my physician.   I have never been asked.

In their defense, doctors weren’t trained to care about things beyond the realm of strict biomedical conditions – acute conditions in other words.   That’s why it is so hard for physicians and many other provider types to get their heads around patient-centered care.   To become more patient-centered providers need to deal with touchy feely issues like personal health goals, personal health beliefs and motivations, family issues, depression, anxiety and all the other human emotions.   A physician I know referred to patient-centered care as a kind of “rabbit hole” physicians just don’t want to go down.  Getting to know the “person behind the disease” is time consuming and can take you down paths you not sure where they end up!

Health care executives, providers and payers wonder why patients aren’t more engaged in their health…aka do as they are told.  The problem isn’t that patients (people) aren’t engaged in their health…they are…the problem is that so much of what is passed off as patient engagement these days (EHRs, PHRs, team care, care coordinators, web portals, decision support tools) are not inherently engaging to us patients!   Why?  Go back and read my personal health goals and explain to how today’s technology-enabled vision of patient engagement is at all relevant to my (and I suspect many of your) personal health care goals.   

That’s what I think.   What’s your opinion?

Post Script

As I mentioned in my last post, I am heading up a research team that will be auditing 2,500 physician-patient conversations recorded during primary care office visits from across the US.   Among the many questions we will seek to answer will be the frequency with which physicians and/or patients raise the question of the patient’s personal health goals.