Co-production in chronic care: exploitation and empowerment

Many scholars have urged firms to empower consumers to become co-producers, arguing that this empowerment leads to a win-win situation that benefits consumers and providers alike. However, critical voices have emphasised that co-production is a way to exploit rather than empower consumers and hence represents a win–lose idea that benefits providers only. Regrettably, these polarised positions remain disconnected and lack empirical investigation. The aim of the present study is to move the debate beyond this stalemate by integrating these perspectives using an empirical study to explore enabling and constraining implications of the attempts to “empower” consumers.

This paper is based on a qualitative empirical study of an internationally unique example of a long-term co-production process in rheumatology care. Data were collected using both focused interviews and observations.

The study indicates that both the optimistic and the critical perspectives of co-production are valid and the implications of “empowering” consumers are two-edged.

The study highlights the need to zoom in and analyse how empowering and disempowering mechanisms relate to specific aspects of particular co-production processes rather than to co-production as a general phenomenon.

The empirical data illustrate the feasibility of employing patients in everyday healthcare production through simple means while raising numerous issues related to, for example, traditional healthcare roles and process design.

The present study of a unique, long-term co-production illustrates how both perspectives of co-production are valid.