Medicine, like everything else in life, has its fads and fashions. Once it was rare for anyone delivering health care to wash their hands between patients. Then it became a fad in some quarters, eventually an expectation for all health care providers, and today has the status of a holy commandment. In fact, even patients and visitors are now encouraged to clean up by taking a few pumps-in-passing from the hand sanitizer dispensers that hang from almost every wall of every clinic and hospital in this country.
Of course, not all medical fads and fashions turn out to be good ones. But some do. I hope that is the case for one of the latest: patient-centered care. It sounds rather odd to hear that for caregivers, focusing on the patient is a “new idea.” I mean, what do they think they’ve been treating all this time? Cabbages and rose bushes?!
But for anyone who has gotten caught up in the health care system due to chronic or acute illness, it’s a little more understandable. Sometimes it seems that to the doctors and nurses, we become our illnesses. Any individual identity that we might once have had disappears into the hustle and bustle of tests, procedures and charting. So, for us, the call to focus on us — the patients — seems right-on.
I’ve watched the growth of this patient-centered movement for a while, and I’m finding it interesting to note what the medical fraternity means by the term—and what it apparently has never occurred to them to consider.
Patient-centered care can mean several different things. One of the most oft-cited is respect for the patient’s values and preferences. Again, it seems odd that someone would have to be told to do this, but OK. I can see where the imperative to treat a condition, and the need to choose between the many options for doing so, might produce a kind of short-sightedness.
According to the Oneview website, dedicated not just to improving patient care but “revolutionizing patient experience,” there are seven other things that health care providers can do to make their practice more patient-centered, such as making sure various facets of the patient’s care are coordinated and integrated with one another, improving the way they communicate information to patients, and respecting (indeed, taking advantage of) the patient’s support network. (See http://www.oneviewhealthcare.com/the-eight-principles-of-patient-centered-care/ for their eight suggestions on how to provide patient-centered care.)
This is all well and good, but there are some who believe it doesn’t go quite far enough. Such approaches maintain the traditional top-down pattern in medical care: the lists of improvements are things that doctors and nurses should do for or to patients.
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