Patient Engagement 2016
Clip
Drawing the Line Between Paternalism and Patient-Centered Care (04:17)

Where do we draw the line between improving people’s health behavior in the direction that we want, versus leaving them happy with what they have? Kevin Volpp, Director of the Center for Health Incentives and Behavioral Economics at the University of Pennsylvania, David Kirchhoff, CEO of Snap Kitchen and former CEO of Weight Watchers, and Wendy Wood, Provost Professor of Psychology and Business at the University of Southern California, discuss how much providers should let patients drive what happens (patient-centered care), and when it might make sense to be more paternalistic.

If a patient makes a well-reasoned, well-informed decision not to change an unhealthy behavior, maybe we shouldn’t push that person, suggests Volpp. On the other hand, for patients who are dangerously at risk, Kirchhoff argues that clinicians can’t shy away from a serious discussion. “You cannot say it’s OK, to just blow it off,” says Kirchhoff. “I don’t know how as a doctor you’re doing your job if you step away from that responsibility.” Wood points to the amount of data on lifestyle behaviors and what diseases are linked to them. We need tax and social policies that are more closely aligned to these data, she says, and the conversation with health care providers should reflect that.

From the NEJM Catalyst event Patient Engagement: Behavioral Strategies for Better Health at the University of Pennsylvania, February 25, 2016.

More From Patient Engagement 2016

Patient Inducements — High Graft or High Value?

Can health care be more like Uber and Lyft?

Consumer Engagement: New Tools and Capabilities for Health System Marketing

Novant Health is using research and data analytics to identify and engage new consumers, develop more relevant products and services, and support its mission and brand promise.

Shared Decision-Making for Good Clinical Care: Better, but Not Easier

Active patient involvement and patient autonomy can be burdensome to patients, especially when they are faced with serious illness. The primary goal of shared decision-making is not autonomy, but good care that fits patients’ lives.

The Patient as Consumer and the Measurement of Bedside Manner

Many physicians do not believe patient satisfaction is a legitimate pursuit. Yet they must meet consumers of health care where they are — on Internet ratings sites.

Halpern02_clip_still: A/B Testing Health Behavior Interventions

A/B Testing Health Behavior

Health care can’t implement changes overnight like Silicon Valley, but we can still learn from their version of treatment and control.

Social Interventions Can Lower Costs and Improve Outcomes

We can better serve our under-resourced patients by helping them access treatments and social interventions we already know to be effective.

Transparency and Trust — Online Patient Reviews of Physicians

Transparency of validated data about delivery-system performance has the power to change the culture of health care.

Patient-Researchers and Physician-Consultants Confront Chronic Disease

Personal-use sensors and data applications allow patients with Type 1 diabetes and other chronic diseases to take charge of managing their health. This is the future of chronic disease management.

Geisinger’s Refund Promise: Where Things Stand After One Year

Geisinger’s radical refund promise at one year — no evidence of financial catastrophe but a good return on patient trust.

My Favorite Slide: One Size Does Not Fit All in Behavioral Interventions

Behavioral interventions can have very different effects in different portions of the population.

Connect

A weekly email newsletter featuring the latest actionable ideas and practical innovations from NEJM Catalyst.

Learn More »

Topics

Reading List: Victor Montori

Mayo Clinic Professor of Medicine Victor Montori shares key papers that have shaped his thinking…

Patient Incentives

50 Articles

Why Real-World Results Are So Challenging…

User engagement outside of clinical trials is the critical factor.

Diversity in Health Care Leadership —…

There’s a clear underrepresentation in the leadership in our medical schools and our hospitals —…

Insights Council

Have a voice. Join other health care leaders effecting change, shaping tomorrow.

Apply Now