You don’t have to read very far on this blog – or even national news outlets at this point – to know that managing one’s own healthcare is critical. However, it cannot be forgotten that the tools and techniques that you use for yourself can be applied when managing someone else’s care. While many find it easier to advocate for others than themselves, it is still worthwhile to stop and ask yourself whether you would know what to do if a loved one had a health event and you became the advocate.

A professional colleague found herself unexpectedly thrust into that role when her mother was diagnosed with a serious and long-term health condition. Even though she had a fair amount of “insider knowledge” about healthcare quality and consumer engagement as part of her job, she still found herself somewhat ill prepared to act as her mother’s advocate – and surprised at how much was really involved in assuming that role.

A recent story on CNN.com addresses this very issue. In “Five must-do’s when a loved one is ill”, Elizabeth Cohen summarizes the five most important things an advocate must do:

• Don't be afraid to intervene
• Ask questions until you understand the answer
• Remember that you know things the doctors don't
• Temper your loved one's enthusiasm for quick fixes
• Scope out the nurses

The article contains much more valuable advice, but the bottom line is that an advocate must be persistent, understand the loved one’s condition, and find allies within the healthcare system.

On its current trajectory, the American healthcare system will increasingly place the primary responsibility for managing one’s own healthcare on the consumer. For better or worse, when navigating the healthcare system, consumers are the ones at the wheel.

The challenges associated with consumers doing the driving on their healthcare journeys are extensive. They will encounter multiple roadblocks along the way that will sabotage their chances for success. First and foremost, education is an enormous obstacle in most cases. Not only do consumers need to take the time to learn about the healthcare system, their health insurance benefits (if they are among those who have coverage), health conditions, and treatment options but they also need to have the ability to find and interpret performance and quality data, review outcome results, and examine cost information to make purchases based on value. All of which needs to be done within an endless mire of acronyms, terms, and buzz-phrases couched in insider jargon. And this is all assuming that consumers even know that they are the ones driving the bus in the first place.

In Dale Shaller’s article in the October issue of The American Journal for Medical Quality ,he explores this topic by asking whose responsibility it is to make sure that consumers are engaged in managing their healthcare.

"For consumer engagement to become a reality, and not just the latest catchphrase in the ongoing litany of health care reform rhetoric, we will need to see concerted aggressive action on the part of multiple stakeholders that are in a position to help consumers and patients assume the wide range of personal responsibilities increasingly expected of them."

Of course there are some substantial upsides to consumers taking on the challenge of managing their own healthcare. No one has a more intimate knowledge of the patient’s health than the patient. The consumer knows things in a way that a provider often cannot. Certainly no one has a more vested interest in a positive outcome than the patient. In an ideal world, a consumer assumes a collaborative role with providers to successfully drive positive health outcomes. However, the current reality requires the consumer to shoulder the majority of the weight, and the current environment makes the load nearly impossible to bear. The system needs change. Shaller suggest employers should play a key role, and cites several good examples of ways employers have creatively engaged employees to effect better outcomes. But most of these are large employers - what about the employees of small organizations? What about the unemployed? Shaller suggests the physician will need to be a key player if this transformation is to occur. Clearly, more efforts need to be made in getting all stakeholders to work together.