Patient-centred practice (PCP), also known as person-centred practice, is a hallmark of high-quality health care. Patient-centred care is an approach that prioritises the patient’s view of their diagnosis and treatment as active participants in their care.
Recent national reviews in the UK, the Francis Report and Realistic Medicine call for a more personalised approach to patient care.
PCP focuses on the individual patient, encouraging doctors to see patients as people rather than biomedical problems. In this way, doctors learn about the broader concerns of the patient and the context of their lives.
Personalised care involves the doctor in getting to know about the patient’s family, home circumstances and interests. The patient also comes to know their doctor, understand their concerns and so develop a trusting patient-doctor relationship. Face-to-face consultations are an essential part of personalised care.
The doctor tries as far as possible to see the world through the patient’s eyes.
In an empathic relationship, the doctor may experience some of the emotions felt by the patient, although not to the same degree as the patient. The doctor listens to the patient’s voice, giving them time to express their ideas, concerns and expectations. Although it is not possible to completely appreciate another person’s views and emotions, in the doctor’s attempt to understand, a human connection is established.
Before any intervention, whether for diagnosis or treatment, the doctor seeks the patient’s voluntary, informed and understood consent.
Seeking consent is much more than gaining a signature on a form – it is a process by which the patient can become involved in decisions and planning about their care. Seeking informed consent is a powerful way of respecting the patient’s autonomy, protecting them from medical paternalism.
Patients prefer to see a doctor who they know and trust.
From the doctor’s perspective, practice is more professionally satisfying and it is possible to pick up on subtle changes, physical and psychological, when the patient is seen in the context of an ongoing relationship. Continuity of care is linked with improved health outcomes.
Patients should be enabled to be involved in decisions which affect their care. Most patients want clear, honest information about their illness and to be involved in their treatment plan. Sensitive communication skills are necessary to enable the patient to ask the relevant questions.
Patients may ask the doctor for their opinion as to what they should do and it does not undermine their autonomy for the doctor to express a view. However, simply abandoning the patient to make decisions without support and information is not morally acceptable. In a trusting partnership, the doctor can acknowledge the uncertainties of practice and support patients in their decision-making.
To find out more about the University of Worcester’s Three Counties Medical School, visit the website.
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