Patient centered care, in my opinion, should be the only kind of care we deliver as doctors,
nurses, PTs/OTs, dentists, pharmacists, etc. It is their life, their body after all and we are only
stewards of their health. Instead of always thinking of ourselves as the leaders in a patient
encounter, I think it is important to step back at times and let the patients lead us or at the very least be our co-pilots.
I had a very eye-opening realization my second year of medical school while trying to create
a course for parents of young pre-school children to help them feel better prepared to raise their children to be healthy and safe. The other students and I had all these great plans for what we wanted to teach and what we thought the parents would want to learn. It was not until a thoughtful, caring, young doctor at Church Health (Dr. Z!) sat down with us to discuss our strategies for launching this project that we realized we were going about it in all the wrong ways. She wisely pointed out to us that the best way to help people learn is to ask them what they do not know. Ask them what they want to learn. I remember thinking how brilliant that was. Of course we would not want to waste time teaching the parents topics about which they were already knowledgeable. It was so simple, yet so groundbreaking for me. So, instead of deciding what topics we would teach the parents, we asked them what they wanted to learn and we were amazed. While many of the parents did request topics we originally wanted to teach, there were multiple suggestions for topics we had not even considered. By taking the time to ask and focusing on the needs of our patient population, we were able to better serve them while also respecting their intelligence and unique input. Ever since then I have used this tool to refocus myself in a lot of clinical situations, and I encourage all of you to try it in your daily practice, too.
On clinicals, I have seen patient-centered care go very well, but I have also seen people
attempt it and make situations worse. It is a very delicate balance. For example, I had one
attending who brought all of his team (including residents, pharmacists, and students) into my
patient’s room to tell her she had a new diagnosis of breast cancer. Yes, we were all standing in a circle around her bed at which she was in the center, but that was not what someone practicing patient-centered medicine should have done in that situation. Half of those people had little or nothing directly to do with her care. I felt that someone practicing patient-centered medicine would have stopped to think about what they would have wanted the doctor to do if they had been in that same situation. I believe most people would have chosen to have only the necessary caregivers in the room. In the end, I think that while we should not assume what our patients want (as I mentioned in the above story), I think it can be very valuable to put yourself in the patient’s position in order to give them the best care you can.