Rediscovering mercy: No longer enabling but empowering the patient

We live in an era in which the word "no" is among the more offensive of phrases. What was formerly a "can do" spirit within our country that suggested that most anything could be accomplished if you worked hard enough and smart enough, has become an overarching license that suggests anyone "can do" anything they want. This has turned an empowering motto into an enabling mantra that has threatened the welfare of our country.

One of the many arenas in which this dynamic has played itself out is in our healthcare system. Primarily made up of staff that are, by nature, caregivers, the healthcare industry has a natural inclination towards "enabling others" because those who are called into a vocation of caring for others are the very people that sometimes have a hard time critiquing someone's unhealthy lifestyle or being the bearer of bad news; instead feeling most fulfilled when making others feel good about themselves or otherwise encouraging those who are in pain.

While attending a conference for orthopedic leaders, the discussion turned to the difficulty of providers coordinating with post-acute care facilities in order to improve their Bundled Payments for Care Improvement (BPCI) stratagem. "The problem is that we don't want to say something that hurts their feelings," one of the group facilitators suggested to the unanimous agreement of those in attendance. This is exactly the case in point, and if this sensitivity exists when coordinating with other care facilities, how much more does it occur in our actual engagement with patients.

While the common attributes of the caregiver are worthy of praise, it would "do no harm" for many of today's clinical care givers to regain a sense of the difficult balance necessary for administering true mercy – that is "the compassionate treatment of those in distress or under their control." As the saying goes, certainly
there are times in which mercy looks like "giving a man a fish" in order for him to eat or feed his family. But sustainable mercy looks like "teaching the man to fish" and then creating appropriate expectations and accountability to ensure that the man is in fact fishing on a regular basis and hopefully teaching others how to do the same.

In order for healthcare providers to evolve back towards a sustainable brand of mercy, healthcare givers will have to adopt sustainable models of care. Today's value-based payment models are helping to facilitate this adoption because providers can no longer afford the "patient as consumer" model of engagement. Instead, if hospitals and their partnering care facilities are going to thrive in an at-risk environment, they must encourage and enforce a "patient as partner" model of engagement; they must teach the patient "how to fish" and create expectations and accountability to enforce their active participation.

Though some may suggest that patients will resist responsibility in their own care, it is important to remember that the model requires proper empowerment for this new role. In educating and empowering patients with best practice knowledge and right-timed tools for coordination, a patient's foundational need for safety and sense of control are relieved. By then adding the needed expectations and accountability, this partnering role will be activated and reactivated until new habits are formed, and these new expectations become normalized for both the clinician and patient.

Acts of mercy are, at times, at the expense of one for the benefit of the other. Sustainable mercy, however, takes time and intentionality that eventually empowers the dependent to become independent, thus creating mutual benefit for both parties involved.

David Brown is the chief executive officer and founder of VOX Telehealth, a leader in the development of procedure-specific, patient engagement solutions. David brings more than 20 years of entrepreneurial experience across several industries, including behavioral healthcare, technology, banking, and retail. David has a deep appreciation and understanding of engaging patients effectively having previously spent a decade overseeing patient engagement for a multi-state behavioral healthcare practice.

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