How Patient-Centered Care Redefines Patient-Physician Roles

Monday, May 9th, 2011
This post was written by Jessica Fornarotto

Patient-physician dynamics change when a practice opts to deliver team-based care, explains Barbara Wall, J.D., president of Hagen Wall Consulting.

The relationship between the patient and physician alters in a patient-centered practice. In shared decision-making, the patient and physician roles have more give and take than in traditional practice, and more patient involvement in developing the treatment plan. In essence, the physician discusses the following issues with the patient:

  • The patient’s understanding of the diagnosis and options for treatment;
  • The patient’s belief and concerns about their illness and treatment options;
  • The challenges they anticipate; and
  • Practical ways to help them with these difficulties.

The patient is encouraged to take a more active role in the visit and to define the type of physician-patient relationship they want, talk with the physician about their health issues, their feelings and their expectations; ask the physician to clarify anything they don’t understand, and participate in care planning and articulate any doubts they have about their ability to follow through on the plan.

In most groups, the adoption of a shared decision-making practice style is influenced by the opinions of formal or informal leaders within the group. Physicians must believe that the approach will have a positive clinical outcome for their patients for them to consider pursuing it. Start with a physician champion with an interest in this practice style, and allow them to lead the way by sharing some journal articles on the subject of their choosing. The most persuasive evidence will probably be the early success stories from your physician champion as they implement the approach. Physician training in shared decision-making focuses on feedback to the physician based on observation of the physician’s interview technique.

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