Want better patient engagement? Help families make better decisions.

Over the past several months, I’ve personally had a front-row seat to a very real, very complex health care decision-making process: my wife is facing major spine surgery. Plagued by chronic back pain for years, she has managed the condition through a combination of exercise, physical therapy, chiropractic care and over-the-counter medications. But when her trusted physical therapist said, “It’s time to think about surgery,” her world changed overnight.
Traditional thinking in health care would argue that no one belongs in the middle of a complex decision between a patient and her physician. But the reality is that after finding an orthopedic surgeon who was highly competent, experienced and specialized in spine surgery, her brief discussion with him had limited impact on her decision of whether or not to move ahead with the surgery.
Instead, she sought answers from other sources to questions ranging from the most serious – What is the 30-day mortality rate for this procedure? – to the most mundane but personally relevant – How soon can I walk my dogs again after surgery?
My wife’s decision-making journey meandered through internet searches, poring over information and videos on the surgeon’s website, personal conversations with friends, and even personal conversations with strangers she met who had experienced the same surgery.
But the most consequential discussion my wife had during this emotionally challenging time was with the surgeon’s nurse. She listened, patiently address every question in a caring but honest and straightforward way, and reassured. And perhaps most importantly, she helped empower my wife during this stressful time by helping her understand what she could do to make the surgery and subsequent recovery most successful. “Your core muscles need to be in the best shape of your life,” she encouraged. And my wife’s plank is up to a phenomenal two minutes!
So how can those of us who are concerned with an individual’s experience at all stages of her healthcare journey help? First, the availability – and usability – of published information related to major health care decisions must continue to improve. Individuals must first understand options before we try to sell them on what we believe is the best approach for them.
But even more importantly, the quality of the interaction between my wife and the surgeon’s nurse can’t simply be left to chance in a population health world. Just as major financial institutions appreciate the impact front-line staff and advisers have on consumer decision-making (think American Express as best case; Wells Fargo as worst case), health care patient engagement strategists must better understand and influence the daunting process individuals face when weighing complicated, expensive, often scary care options. This focus will determine whether our role is viewed by our industry and executive colleagues as a glorified customer service adviser or thoughtful consumer behavior strategist who can influence critical decisions and even the outcome of care interventions.