Passing the baton: Will patients take it?

In the public areas and examination rooms of the Southeast Texas Medical Associates (SETMA) offices in Beaumont, there is a poster of a baton being handed off.

The caption reads:Firmly in the provider’s hand, the baton – the care and treatment plan – must be confidently and securely grasped by the patient, if change is to make a difference, 8,760 hours a year.”

SETMA chief executive officer Dr. James Holly points out that the health-care provider carries the baton just 0.68 percent of the time while the patient does so the other 99.22 percent of the time.

“Coordination of care between health-care providers is important, but the coordination of the patient’s care between the health-care provider and the patient is imperative,” he says.

The baton represents the treatment plan. Holly describes the treatment plan as “the engine through which the knowledge and power of the health-care team is transmitted and sustained.”

Holly says the baton must be transferred to the patient by ensuring that she or her caregiver is equipped and empowered to carry out the care plan successfully.

That is the essence of patient engagement.

However, patients are not doing such a great job with that baton.


  • About 7 out of 10 Americans die of chronic disease.
  • Nearly 2 out of 3 personal bankruptcies involve medical costs.
  • More than half of Americans delay medical care because of cost.
  • More than half fail to get an annual flu shot.
  • Nearly 1 out of 4 statin users thought they would be cured after a 30-day prescription.
  • Only 1 out of 8 Americans have proficient health literacy.

According to a 2013 Centers for Disease Control survey on lifestyle choices, 6 out of 10 are overweight; 1 out of 5 smoke and fewer than half of them tried to quit in the past year; and 1 out of 3 get virtually not exercise.

Physicians can improve their patients’ health only if the patients do their part. Physicians need engaged patients to succeed. Too many patients are not holding up their end of the bargain.

Do not smoke. Eat at least five daily servings of fruits and vegetables combined. Drink moderately at most. Exercise at least 30 minutes a day. Sounds easy enough. But only 3 percent of Americans do all four.

Those who fit the American Heart Association’s ideal cardiovascular profile are even rarer. According to University of Pittsburgh researchers, the profile included seven factors: body mass index of less than 25; untreated cholesterol under 200; blood pressure below 120/80; fasting blood sugar level below 100; exceeds the government-recommended physical activity guidelines; does not smoke; and follows a heart-healthy diet. Of 1,933 people between the ages of 45 and 75, only one person met all seven conditions. Fewer than 10 percent met five or more of the criteria.

The federal government’s Healthy People 2010 initiative tracked 733 objectives. Americans had achieved 172 of them – or fewer than 1 out of 4. There was important progress on heart disease since 2000, but obesity and diabetes went in the wrong direction. Rates of smoking and healthy eating rates essentially stayed the same.

Lifestyles of many older Americans have become increasingly unhealthy in the past 20 years. The percentage of those ages 40 to 74 who say they have at least five daily servings of fruits and vegetables combined declined by nearly half. The percentage who worked out 12 times a month was 43 percent, compared with 53 percent in 1988. Even those who had acquired heart disease, high blood pressure or diabetes were no more likely to change their bad habits than those without the conditions.


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