In spite of its strong endorsement more than a decade ago, patient-centered medicine — doctor-patient relationships that center on a patient’s needs, values and concerns — has yet to go mainstream.
“We are only at the water’s edge in terms of availability of patient-centered care studies because they aren’t being done,” says Richard M. Frankel, Ph.D., senior author of a new review of medical studies on the subject.
“We need to encourage researchers to implement clinical trials that evaluate care that focuses on communication between physician and patient. Ultimately, we need processes that have been tested and proven.”
In the paper that appears in the current issue of the Journal of General Internal Medicine, Frankel uses an analogy from aviation where safety is given the highest priority.
“When the air traffic controller gives an instruction to the pilot, the pilot’s response must be phrased to indicate understanding of the air traffic controller’s message. We don’t have that in medicine. The doctor speaks to the patient and generally does not solicit a response that clearly indicates the patient understood what the doctor wished to convey.”
As with the cockpit and control tower exchange, the exchange at the hospital bedside or in the doctor’s office requires communication of complex information in stressful circumstances. In both aviation and medicine, good communication is critical to safety.
“What we have found repeatedly is that medical care succeeds when there are stable and enduring relationships,” said Frankel.
“Successful outcomes lie not simply in the mechanics of medical care, but in the social and emotional context of the doctor-patient relationship.”