Patient Power and Empowerment: Mitigating Elements of Valuable Patient Participation in Healthcare Collaboratives

Abstract

During the last decade, the public healthcare sector has had to deal with increased competition, a growing influence of patient associations, and a necessity to deliver health services more efficiently and effectively. Despite recognising the patient participant’s role as a critical stakeholder in value creation, there is a limited body of research on the influence and power of patient participants. This article focuses on regional health improvement collaboratives that aim to develop coordinated, multi-stakeholder solutions to their healthcare cost and quality problems. They meet regularly and include health professionals, health insurance providers, and patient participants. In this article, we explore the relationships between these stakeholders and patient participants’ interpersonal dimensions regarding empowerment and valuable collaboration. Data were collected through stakeholder observations during meetings of three regional health improvement collaboratives, as well as through semi-structured interviews with the patient participants involved in these cases. Results show that patient participants can be empowered on a personal level. However, this does not imply that patient participants are empowered within the group dynamics. Interpersonal relationships constitute a crucial hidden aspect of building trust. More dialogue and inquiry are needed to examine how patient engagement is enacted and positioned within healthcare collaboratives.

An end to the “muffin meeting”: Conceptualizing power and navigating tokenism in patient engagement for health leaders

“…From a Foucauldian perspective where knowledge and power are constitutive of each other, one can draw connections between knowledge enacted within institutions by actors deemed to have legitimate claim to that knowledge and the development of professional dominance and paternalism within healthcare settings. 20 While PE has been positioned as an evolution against paternalism in healthcare, 8,14 it is reasonable to consider how professional dominance continues to complicate the objective of creating equal partnerships between healthcare organizations and patients. Healthcare organizations are highly professionalized and this professionalization creates organizational cultures predicated on "normal ways of doing things."…”

“…While efforts have been made to bring attention to the importance of power in the context of PE and the need for healthcare actors to recognize and attend to imbalances of power, 2,14 deeper analysis of various philosophical conceptualizations of power could be valuable to health leaders seeking to better understand and navigate it within PE efforts.…”

“…Allow time for knowledge and experiences to be shared and for trust to be built. 14 Ask how the relationship can be improved. Ask for feedback and provide it to others.…”

“…While PE has been positioned as an evolution against paternalism in healthcare, 8,14 it is reasonable to consider how professional dominance continues to complicate the objective of creating equal partnerships between healthcare organizations and patients. Healthcare organizations are highly professionalized and this professionalization creates organizational cultures predicated on “normal ways of doing things.” 4,21 In essence, healthcare professionals hold the technical knowledge needed to deliver care or administer services, as well as the experiential knowledge of enacting those services through the norms of an organization.…”