One of the best investments my wife and I ever made was $1,000 for a midwife for the delivery of our second child. For this we got a stream of advice and a few visits before the delivery and then she was with us throughout the delivery.
The woman in question had been head nurse – perhaps called ‘matron’ but that just makes me think I’m watching a Carry On movie – at an obstetrics ward. The best thing about it was not all the things that people think about with midwives – that they might be a tad ‘alternative’. They’re certainly well informed about a bunch of practical things that the Obstetricians are strangely oblivious to. But that’s not the really good thing.
The point about this woman was that in a massive system, where we’re tired, outnumbered and hopelessly outgunned in expertise, she was our advocate. So when there was a changeover of the official midwife in the ward and the new, one started bossing us around, when I was on the verge of completely losing it with this woman’s robot routine, our own midwife just took over and got done what I wanted without anyone having to be punched out (it would probably have ended up being me).
So I’d like to see this kind of role developed more fully. Whenever one had a substantial medial procedure or problem a ‘medical advocate’ would husband you through the system. You’d pay them to help research the condition, help you research, choose and quiz specialists and so on. Of course it would be quite expensive, but I’m sure I’d be happy to pay for it at least in some circumstances. And there’s plenty of money flying around so there would be at least some market for it. In a way an architect has a role a little like this in building a building – of being the impresario – a person who is at the apex and makes it all happen – and happen well.
I was reminded of this when Tim Watts sent me a link to a post of his about ‘information therapy’ which comes at similar ideas but from a different (informational) angle.
Seidman and Sepucha propose that health providers ought to work with these changes in citizens information consumption and provide tailored information therapy to help patients care for themselves. As the PPI describes it:
For example, a doctor who has just told a patient that she has diabetes could follow-up the visit with an email with links to information about managing diabetes. The patient will be much better equipped to process the information at home with the support of loved ones. Today, that process happens with haphazard web searches without any feedback going back to a physician or a nurse about whether the patient has found reliable information and has begun to master the disease.
Its easy to see how such information therapy could involve connecting patients to online communities of patients with similar conditions, harnessing the new cooperatives identified by Tom Watson MP. The potential of linking information therapy of this kind with electronic patient records (of the kind that Google and Microsoft are now working on) would be enormous.