This profile was prepared when Pedro Chaná was elected to the Ashoka Fellowship in 2006.
The New Idea
Pedro has established a network of “clubhouses” to treat people with chronic disorders, allowing physicians, patients, and patient associations to make clinical decisions by consensus. This network replaces the traditional clinical relationship in which the physician is the expert and the patient is a passive subject identified primarily by a diagnosis. In this collegial healthcare environment, patients receive medical attention from a team of specialists including neurologists, psychiatrists and occupational therapists. Pedro’s clubhouses are the nuclei of new health communities. They enable people to deal with chronic illness and to rebuild their lives, not just recover from a disease. They change the economics of treatment by allowing people to share the costs of medication. At the same time, they re-educate physicians in how to personalize their expertise and make it more effective. The focus is to leverage the strengths of patients, rather than emphasize their physical limitations. This shift is underscored with a semantic change: the Center for the Study of Motor Disorders (CETRAM) works with “members” not “patients.” Pedro first implemented his design for people with motor disorders but is now applying it to other long-term conditions such as stroke recovery. His approach represents a profound shift in perspective and attitude for physicians. Through university programs and work placements, Pedro is educating the next generation of physicians to see the value of this democratic approach to healthcare.