The patient should be the judge of patient centred care

Primary care p 468

Key messages about patient centred care can be drawn from the paper by Little et al in this issue of the BMJ (p 468).1 Firstly, strong agreement exists between the definition of patient centredness that arises empirically from this observational study of patients in the United Kingdom and another definition arising from reflections on practice in South Africa and Canada,2 suggesting an international definition of patient centred medicine. Secondly, the premise of the observational study is correct—that the best way of measuring patient centredness is an assessment made by the patients themselves.

Patient centredness is becoming a widely used, but poorly understood, concept in medical practice. It may be most commonly understood for what it is not—technology centred, doctor centred, hospital centred, disease centred. Definitions of patient centred care seek to make the implicit in patient care explicit. Such definitions are, we recognise, oversimplifications which help in teaching and research but fail to capture the indivisible whole of a healing relationship. Perhaps qualitative research comes closer to conveying the qualities of such care.

Acknowledging these limitations, researchers seek answers to crucial questions …