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How Patient-Centered Care Keeps Evolving

By Dr. Clint Cheng, family medicine physician and CMO of the St. Joseph Medical Group

In the general marketplace, the customer is always right. Patient-centered care takes a similar approach. Instead of telling patients what to do—because we know best—patient-centered care puts patients firmly in the center of their care team. In medicine, this hasn’t always been the case.

Historically, hospital processes tended to focus on efficiency and physicians rather than what the patient thought or wanted. In patient-centered care, we aim for shared decision-making,  ensuring patients are an integral part of their care team. Yet this approach also comes with obstacles. 

Our job is to provide the highest quality care based on evidence-based medicine. However, patients don’t always understand the evidence guiding their care decisions, so they can’t always get what they want. Additionally, the complexity of the health care delivery system makes it impossible to view the patient-physician exchange as simply transactional. Despite these impediments, patient-centered care is here to stay and evolve.

The Birth of a New Approach

The first hints of patient-centered care appeared in the 1950s, but it really started to develop in the twenty-first century. It has since gained momentum and shows no sign of slowing down.

Technology plays a key role in the growth of patient-centered care. It pushes us toward innovative care. Whereas physicians were once the gatekeepers of medical information, patients today can research their symptoms and conditions, gain a better understanding of their health and more fully participate in their medical decision-making. 

These are great developments, but patient access to medical information can also create challenges, as most doctors have experienced firsthand. Some patients do not fully understand or accept the limits of the knowledge they find on their own, which is only worsened by the abundance of misinformation and social media messaging. In some cases, access to medical information reduces trust in doctors’ ability to make the best evidence-based medical decisions. 

Though it may seem counterintuitive, making patient-centered care the backbone of your organization can help resolve or limit these problems.

Embracing the Patient Perspective

No one would argue that involving the patient in decisions about their care is inappropriate. While we cannot compromise on evidence-based medicine, health care has traditionally focused on the industry’s goals, sometimes to the harmful exclusion of patients we lost sight of when they needed us the most.

The shift to patient-centered care has brought a much-needed balance to health care. Instead of being paternalistic, patient-centered care is collaborative. Done properly, collaboration provides an avenue for better care. It transforms the patient-physician relationship into a partnership that satisfies both parties.

The NEJM Catalyst presents the following benefits of this approach:

  • Better use of resources

  • Enhanced reputation within the community served

  • Improved patient satisfaction scores

  • Increased productivity and morale within the health care team

  • Lowered cost of care and increased financial margins
     

Moving Toward Patient-Centered Care

Beneficial as it is, adopting patient-centered care requires intentional effort from administrators, physicians, nurses and pretty much everyone on the health care team to reap the rewards—and should be practiced 24/7. 

St. Joseph Health team members have been on a patient-centered journey for more than a decade to carefully hone the patient experience. Guided by the Studer principles of excellence, accountability, communication and others, our collective goal—our agreement— is to enhance every aspect of the patient experience as much as possible.

Ideally, hospitals and clinics should develop a patient-centered environment designed to evolve, one that can seamlessly adopt new policies and processes that reflect patient needs. Health leaders can take the following steps:

  • Leverage technology. Provide patients easy access to personal health records and make sure physicians are accessing the same records to improve efficiency and continuum of care. Give patients options for scheduling appointments online and using virtual care. 

  • Walk through the patient process with frontline team members to gain firsthand knowledge of the patient experience. You can’t know unless you’re there.

  • Adjust policies based on regular, ground-level assessments of the patient experience.

  • Consider no policy or procedure off limits to change—listen to the ideas of others.

  • Perform patient experience surveys, review the data regularly, and act on the findings.

  • Provide support to frontline medical staff to prevent burnout, an issue we know has a direct impact on patient care.

  • Provide price transparency about the services you offer. Not only is it the law, but it’s also the right thing to do.

The Patient Focus Is No Longer an Option

Patient-centered care is now widespread. Health professionals can no longer ignore this cultural norm without consequence. Patients realize the personal power they have about their health care, and most know they can go elsewhere if they choose.

However, always giving patients what they want is also potentially dangerous. Putting best practices aside in an effort to retain them isn’t the best policy. Not only does it go against the Hippocratic oath, but it can also harm the patient. Don’t grapple with a dichotomous mindset—do everything the patient wants or to do everything medically appropriate—the goal should be to include the patient in the decision-making process and carefully explain how your care plan is designed with their best interest in mind. 

Physicians must take time with their patients, thoroughly explain medical conditions and why they are happening, and discuss treatment options and why one therapy is preferred over another. This develops the kind of trust that a good patient-physician relationship is built upon, and helps patients engage in difficult conversations with an open mind. Improved compliance and better outcomes should follow.

Patient-centered care positions you as the go-to specialist patients trust.

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