My colleague Trisha Torrey, About.com Guide to Patient Empowerment, recently wrote about a novel concept in patient care: patients who don't always need to see their doctors. The idea is that there are some patients (probably many of you reading this right now) who are so educated and knowledgeable about their condition that they might be able to manage their own medications.
These patients, which we sometimes call "savvy patients" or "patient experts," are often capable of recognizing and diagnosing their own symptoms. They know what they need, but they must see their physician in order to get a new drug or a change in dosage. They might begin to feel as though their physician is a stepping stone instead of a guide in their journey to wellness.
Trisha reported on a conference she attended where Dr. Jane Brock from the Colorado Foundation for Medical Care shared her idea: let the patient expert write their own prescriptions. There would be limits, of course, to the type of prescriptions that could be written, and the prescription pads would look different than a physician's pad so they could be recognized as a patient pad. Dr. Brock postulates that implementing this system could result in benefits both for patients (savvy or not) and for overworked physicians.
At first read of Trisha's blog, I thought this could be a good idea. I resisted the urge to blog about it right away because I wanted to think about it some more, though. It has obvious benefits for patients, but it has some drawbacks as well. And, quite frankly, while this system might be beneficial for use with some chronic conditions, I don't think it has a place in the arena of inflammatory bowel disease (IBD).
Many of us with IBD, myself included, keep up on all the latest research about IBD and related conditions. We often know when a flare-up is coming, and when we might need to see the doctor to nip it in the bud. We also know how often we should have bloodwork or colonoscopies done.
Even so, I think IBD is far too complicated a disease for a patient to be able to write themselves a prescription for prednisone or an anti-TNF medication. The drugs used to treat IBD can be very effective, but they also come with a laundry list of potential side effects and interactions that need to be closely monitored.
IBD tends to make a person very sick very quickly. Going into that doctor's office is a good way to evaluate mental and physical state, and that can only be done if a doctor sees their patient in person. If a patient were writing their own prescriptions for IBD, they could get very sick indeed before finally seeing a physician.
What do you think? Should patients with IBD have their own prescription pads?
Photo © Cathy Kaplan