Towards a global definition of patient centred care
Dear editor,
Moira Stewart's plea for patient centered care (BMJ 2001;332;444-5),
overlooks two issues. First, patients need health education so that they
can appreciate the reasons behind health interventions. Without medical
knowledge, these interventions are indistinguishable from the rituals of a
charlatan. For example, unless a person understands the concept of
atherosclerosis, expecting them to change their diet to lower their serum
cholesterol means as much to them as asking them to carry a lucky rabbits
foot. Second, a seven or ten minute consultation does not provide time to
explore patients' concerns or even describe how to take a medicine
properly.
The nation needs educating about health. Either half the population
needs to train as health professionals or some other way of distributing
knowledge needs to be found. School might be a start, with less about
Henry VIII's wives and more about the human body. For adults, the internet
may be one answer. Working with people who have a basic understanding of
how their body functions is easier than than starting from scratch.
NHS Consultations are too short to be centred on anything, let alone
the patient. Dissatisfaction is expressed by both sides - from the patient
by their complaints and by the doctor with stress, depression and burnout.
Lengthening the consultation, as well as allowing more members of the
health care team to consult would be a start.
Patient centred care needs proper foundations that require profound
changes throughout society and the healthcare system. It cannot be tacked
on as an additional extra to please politicians and sociologists.
Rapid Response:
Towards a global definition of patient centred care
Dear editor,
Moira Stewart's plea for patient centered care (BMJ 2001;332;444-5),
overlooks two issues. First, patients need health education so that they
can appreciate the reasons behind health interventions. Without medical
knowledge, these interventions are indistinguishable from the rituals of a
charlatan. For example, unless a person understands the concept of
atherosclerosis, expecting them to change their diet to lower their serum
cholesterol means as much to them as asking them to carry a lucky rabbits
foot. Second, a seven or ten minute consultation does not provide time to
explore patients' concerns or even describe how to take a medicine
properly.
The nation needs educating about health. Either half the population
needs to train as health professionals or some other way of distributing
knowledge needs to be found. School might be a start, with less about
Henry VIII's wives and more about the human body. For adults, the internet
may be one answer. Working with people who have a basic understanding of
how their body functions is easier than than starting from scratch.
NHS Consultations are too short to be centred on anything, let alone
the patient. Dissatisfaction is expressed by both sides - from the patient
by their complaints and by the doctor with stress, depression and burnout.
Lengthening the consultation, as well as allowing more members of the
health care team to consult would be a start.
Patient centred care needs proper foundations that require profound
changes throughout society and the healthcare system. It cannot be tacked
on as an additional extra to please politicians and sociologists.
Yours sincerely
Dr Liz Miller AKC, FRCSE, MRCGP
Director www.med4u.co.uk
38 Harwood Rd Fulham SW6 4PH
Competing interests: No competing interests