Patient-dictated vs. patient-centered care. What can physicians do?

Patient-centered care (PCC) seems to be a popular buzzword among policymakers and administrators in recent years. Indeed, many physicians see our health care system as payer-centric, many patients see it as physician-centric, and no one seems to see it as patient-centric. While putting the patient at the center of what we do as physicians is critical to improving the triple aim of better care, better health, and lower costs, it is important to keep in mind what this exactly means; PCC is not the same as patient-dictated care (PDC). We have all experienced patients who demand certain tests or treatments and see the physician’s role as merely rubber-stamping whatever is desired. This is a common trait among millennials, but also older generations who now have access to all sorts of information, both correct and incorrect, through the internet. Often these requests are accurate and warranted, but often they go against medical evidence or our clinical judgment as physicians. The example often given is of a patient with a viral upper respiratory infection who demands antibiotics. Many physicians fear negative patient satisfaction scores or losing a patient in a competitive market, and so will prescribe the antibiotics as the patient requests. This has obviously negative ramifications for antibiotic resistance and poor care, but these are the incentives that have been set for us by many payers and administrators. It is only human nature to follow the incentives. Continue reading ...
Source: Kevin, M.D. - Medical Weblog - Category: Journals (General) Authors: Tags: Physician Primary care Source Type: blogs