Respect for patient’s values, preferences, and expressed needs are some of the key dimensions of care defined by the Picker Institute. Recent studies reveal that patients perceive changing their communication behavior with health care providers will disrupt rapport and affect their quality of care. (Towle et al. 1999)

Health professionals recognize the importance of patient participation in decision making. The development of patient competencies has been demonstrated with the utilization of specially trained Health Coaches that may be registered nurses or other healthcare professionals. Providing evidence based information, helping patients formulate key questions, and encouraging individuals to explore their own problem solving process are methods in which Health Coaches help patients develop the competencies necessary to become empowered healthcare participants. Patients in the US may take a more active role in healthcare decisions due to the nature of insurance co-pays, other out of pocket expenses, direct to consumer marketing of pharmaceutical products, and access to healthcare information via the internet.  Measurement of success in patient empowerment in the US may be accomplished using claims data, patient comment lines, and satisfaction surveys. 

What happens when the healthcare environment is a socialized medicine delivery system?  Will patients participate in and accept responsibility for their healthcare decisions?    In the UK- the healthcare system is highly focused around the GP (general practitioner).  All patients are provided with basic healthcare through the National Health Service (NHS).  The system remains to this day rather patriarchal with patients yielding to the decisions and recommendation of the GP.  The intervention of professionals trained in Health Coaching methodology positively impacts the patient-provider relationship.  Barriers to this approach exist however, as a US model is translated into the UK healthcare environment.

Towle, A. & Godolphin, W.  (1999).  Framework for teaching and learning informed shared decision making.  BMJ, 319(18), 766-769.