Patient-centered Care

The New England Journal of Medicine published an opinion piece this week entitled “Defining ‘Patient-Centered Medicine“. Now to those of you who are fortunate enough to have avoided time in the ER, hospital or multiple doctors offices, this may seem obvious. All care should be patient-centered, right? After all, that is what it’s about, taking care of the sick person or helping a well person stay that way. For the rest of us, who have had the misfortune of being ill or helping a loved one navigate our healthcare “system“, it is obvious that we could call our system “insurance company centered” or “healthcare provider centered” or “government centered” or “pharma centered”.  Rarely does anyone stuck in the middle of a disease process entailing many specialist and hospital visits feel like they are the center of the medical universe.

At its best, a patient-centered therapeutic milieu would consist of a supportive environment where communication is the highest value followed by caring, well-trained, humble providers who are not impeded by the needs of profit-driven pharma, insurance companies, hospitals or providers. As anyone who has made the journey will attest to, if you are going to spend an extensive amount of time in our health care system, you need to be a well-informed self-advocate OR have an advocate beside you every step of the way. You need to question every doctor and nurse that treats you unless and until you are sure they deserve your complete trust. And we “healthcare providers” need to be open to the questions and do our best to answer them and find specialists who are not offended or unnerved by the questions. Patients and doctors must provide the “push back” necessary to change this system for the better.

It is hard to get past the avarice of the many entities involved and see a better way of treating patients, but a dash of common sense would sure improve a lot of the system problems I see every day. To quote my favorite again: “The practice of medicine is an art, not a trade; a calling, not a business; a calling in which your heart will be exercised equally with your head. Often the best part of your work will have nothing to do with potions and powders, but with the exercise of an influence of the strong upon the weak, of the righteous upon the wicked, of the wise upon the foolish.” William Osler MD

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