Research supports what many of us are likely to have already experienced: there is a physician shortage — and it’s going to get worse. Clinicians are seeing the impact firsthand, with patients on long waitlists for appointments and too often turning to the emergency department (ED) for issues that could have been managed in a primary care setting or a specialist’s office. With the aging population and physicians reducing their patient-facing hours, it is likely that most Americans will continue to feel the strain of a reduced healthcare workforce. Meanwhile, remaining doctors will be even more stressed and overworked.
Given these barriers, we would be well served by devoting more attention to patient education and health literacy. Several factors are already reshaping the way patients engage with their own health, prompting a shift toward greater self-management.
Accessible medical records are now the standard, and patients can often immediately view their own medical notes and lab tests. While physicians were initially very concerned about how that access would work out (could patients understand the information? Would many more new questions result?), the benefits have outweighed the drawbacks for many patients. It has also led to newfound methods of patient engagement; for example, many patients now actively review their medical records and ask informed follow-up questions in the portal. We could, however, be using these tools more effectively by making portions of the notes easier for patients to understand and by providing clearer summaries and instructions designed for patient use.
We should also recognize that patients, when facing care access delays, may be more likely to turn to self-management and over-the-counter (OTC) options for minor health concerns. The number of medications and at-home diagnostic tests available in the drugstore has increased dramatically over the years. People have become much more adept at using these tests — from pregnancy tests to COVID-19 screening. However, walking into a pharmacy today can also be overwhelming for patients, given the ever-increasing choices of vitamins, medications, home health equipment, and diagnostic tests. A key part of education is enhancing patients’ understanding of the basics behind common OTC treatments. For example, should they choose the “name” brand or product that has been heavily advertised? Should they ask the often-overworked pharmacist for advice? Or should they just hope to make the right choice? When it comes to the latter, it’s also critically important to make sure patients know how to navigate potential health misinformation online and to prevent them from falling victim to sometimes misleading claims from the wellness industry.
Making sure that patients have tools, whether provided by physicians, educators, or consumer-facing organizations — or all three — to manage these decisions is increasingly important.
No one is suggesting that “Dr. Google” should take over. However, given that patient education may be ever more important in the years to come, we should advocate for health education to evolve to meet this growing need. Getting people started young, via middle and high school health classes, should be the goal. In addition to teaching about nutrition, the curriculum could include the basics of health literacy and prevention. Topics like how to read an OTC medication label, understand basic symptoms, or how to recognize when a condition is serious enough to warrant a doctor’s visit could be part of broader public health initiatives aimed at helping people take charge of their health. This could be a pivotal shift, making health management a routine part of life for the next generation. Trusted, standardized sources of information will be essential in equipping future generations with the knowledge needed to navigate an increasingly complex healthcare landscape.
While increased patient health literacy has clear benefits, home-treatments are not without risks. Self-diagnosis and self-treatment carry the potential for misinterpretation, misuse of medications, and delays in seeking necessary medical care. Patients may overlook warning signs of serious conditions, leading to worsening health outcomes. Additionally, reliance on non-evidence-based online sources or social media for medical advice can introduce misinformation, potentially exacerbating health issues.
Healthcare providers and health educators must remain vigilant in guiding patients toward reputable sources of health information and reinforcing the importance of professional evaluation when symptoms persist. As patient self-management increases, the role of clinicians in providing clear, structured education — whether through primary care visits, pharmacist consultations, or digital health tools — becomes even more critical.
At the end of the day, while the physician shortage presents systemic challenges, one part of the solution may come down to empowering patients to engage in their care through health education and self-awareness. Strengthening patient engagement and education is not about replacing providers but rather enhancing the efficiency of the healthcare system — ensuring that limited resources are allocated where they are needed most.
Alexa B. Kimball, MD, MPH, is a professor of dermatology at Harvard Medical School and president and CEO of Harvard Medical Faculty Physicians at Beth Israel Deaconess Medical Center in Boston.
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