WHITE OAK, MD – Physician professional organizations are offering online teaching aids for clinicians to get up to speed on patient-centered care because it was not taught in medical school.
Today, putting the patient at the center is fast becoming a critical part of healthcare quality efforts, such as meaningful use of electronic health records.
The American Board of Internal Medicine (ABIM) offers online performance modules for physicians based on surveys of dozens of patients and their experience with the care they received at office-based practices. The surveys show where clinicians can make changes that are meaningful to patients, said Eric Holmboe, MD, ABIM chief medical officer.
The ABIM online tool used as part of the board’s maintenance of certification is an example of how physicians can learn patient-centered care as one of their core medical skills, one they can make part of their daily practice.
Surveys are useful when they capture patients’ experience and how it relates to their quality of care and outcomes and functional status. Patients who had better experiences with their providers were more likely to adhere to their treatments, which may yield better outcomes, such as in control of high blood pressure and diabetes, he said.
“It’s hard to practice patient-centered care without the patient’s voice,” Holmboe said at a recent conference sponsored by ECRI Institute and the Food and Drug Administration.
The American College of Physicians (ACOP) also has tools for physicians to understand patient-centeredness as key to the medical home model.
To help physicians understand and transform their practices to a medical home, ACOP has developed a web-based program called Medical Home Builder, said Steven Weinberger, MD, ACOP executive vice president and CEO. The tool has 12 modules, including one on how to organize their practice, work as a team, communicate with patients, and coordinate across providers and settings.
One of the modules offers a practice “biopsy,” which presents a series of questions aimed at determining how effectively the practice provides patient-centered care. ACOP also tools to help physicians on that score.
Clinicians have to be up to speed on patient-centered care, Weinberger said, because the healthcare system is changing from “an individual-based sport to a team-based sport.”
“That means there must be coordination of care across providers, and it must be seamless so the ball is not dropped through the patient-centered medical home and the medical home neighborhood,” he said.
Patient-centeredness should be a part of education in medical schools, training for residency and included within competencies for certification and re-certification, according to the two physician executives.
To be certified by ABIM, physicians must demonstrate medical knowledge, patient care and procedural skills, interpersonal communication skills, professionalism, systems-based practice, and practice-based quality improvement, Holmboe said.
“We have to empower the physicians to have the competencies to help patients elevate their own competencies,” he said.
The healthcare system should be helping patients acquire the literacy to understand risk and to advocate for themselves so they can make good decisions to manage their care, especially those with chronic diseases, Holmboe said.
David Hoyt, MD, executive director of the American College of Surgeons, said most medical school faculties today are being asked to teach and evaluate activities they never experienced.
“We weren’t taught patient-centeredness, quality improvement science, what systems look like,” he said. “Ironically, we’re trying to play catch up at the same time we’re teaching it to our trainees. That’s going to be a challenge, but an opportunity for co-learning.”
