Physicians must learn how to put patients in the center
Physicians need to learn "patient-centeredness" as one of their core medical skills so they can incorporate it into their daily practice. But many clinicians are unfamiliar with what is involved in practicing with the patient at the center of his or her care, despite it being a foundation for improved quality and new delivery models.
Some physician professional organizations are stepping up to offer teaching aids about patient-centered care.
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 physician executives of professional organizations.
[See also: Patient-centered healthcare is essential healthcare.]
To be certified by the American Board of Internal Medicine (ABIM), physicians must demonstrate medical knowledge, patient care and procedural skills, interpersonal communication skills, professionalism, systems-based practice and practice-based quality improvement, said Eric Holmboe, MD, chief medical officer for the ABIM. Patient-centeredness fits into all these competencies.
"We have to empower the physicians to have the competencies to help patients elevate their own competencies,” he said at a Nov. 29 conference on patient-centeredness in policy and practice sponsored by ECRI Institute, a healthcare quality and patient safety researcher, and the Food and Drug Administration.
The healthcare system should be helping patients to acquire the literacy to understand risk and to advocate on behalf of themselves, so they can make good decisions to manage their care, especially those with chronic diseases, Holmboe said.
“Patient feedback on their experience and satisfaction can be used as part of the certification process,” he added.
ABIM offers online practice improvement modules for physicians and residents based on surveys of dozens of patients and their experience with care they received at office-based practices. The surveys show where clinicians can make changes that are meaningful to patients.
Surveys are useful when they capture patients’ experience and how it relates to their quality of care and outcomes and functional status, Holmboe said. Patients who had better experiences with their providers were more likely to adhere to their treatments, which may yield better results, such as in high blood pressure control and diabetes control.
“It’s hard to practice patient-centered care without the patient’s voice,” he said.
The system of care delivery is changing from “an individual based sport to a team-based sport,” said Steven Weinberger, MD, executive vice president and CEO of the American College of Physicians. Patient-centeredness is the key to the medical home model.