Beyond the Prescription - A New Way to Heal

Imagine This…

You're feeling under the weather, with a persistent cough that just won't improve. You visit the doctor, hoping for answers and some relief. However, instead of a meaningful conversation, you're met with medical jargon and handed a prescription before you've even had the chance to fully explain how you're feeling, share your biggest concerns, or get your questions answered. Does this sound familiar?

Now picture this: you walk into a different doctor's office, and instead of a one-sided lecture, you engage in a real conversation. Your doctor listens closely to your concerns, asks questions about your lifestyle, and works with you to explore reasons why the persistent cold could be, later carrying out necessary investigations to confirm what he has shared with you. You then together, discuss treatment options that fit your needs and preferences, which options are not necessarily (but can be) antibiotics and accompanying medication.

Which scenario sounds more empowering? Which do you think leads to better recovery?

Did you know that the second scenario is actually what is recommended in quality healthcare delivery? That should be the standard, regardless of the medical setting.

This is the essence of Patient-Centered Care. It is a revolutionary approach to healthcare where YOU become the captain of your health journey.

What then, is Patient-Centered Care (PCC)?

PCC is more than just a philosophy, it’s a collaborative approach that shifts the focus from a doctor-dominated model to one where the doctor and patient are partners in managing your condition. A meeting of two experts: one is an expert in the illness experience and the other is an expert in the science, the knowledge, the disease.

Here are the key aspects of PCC:

Understanding what exactly this is, could change the way you view your next health consultation and even healthcare provider.

• Shared decision-making: Patients are empowered to understand their health conditions and participate in deciding the best treatment plan. This follows from the principles discussed on health literacy in the last edition of this newsletter (link ). A patient who deeply understands their condition holds the power to navigate their health with confidence and clarity.
• Respect for values & preferences: Your care plan is tailored to your unique needs, lifestyle, and cultural background. This facilitates adherence to the management plans given by your provider.
• Open communication: Clear, simple and two-way communication that minimises complex medical jargon, is vital to ensure you make informed decisions about your health. This facilitates better understanding, satisfaction and adherence to treatment, and therefore improved treatment outcomes.

As a family physician, this approach has been a game-changer to the way I practice medicine. Prioritising patient wellbeing through this partnership model has led to a personal mission towards promoting health and wellness for individuals as a clinician. Patients and doctors therefore partner towards the best possible health outcomes, considering the patient’s context and wellbeing.

The Benefits of PCC

The question is: Why should you even care about PCC? The urgency is in this: that it benefits everyone, both patients and physicians alike.

Studies show that PCC is associated with better recovery rates, reduced hospital readmissions, and lower healthcare costs. For instance, a systematic review published in The Journal of the American Medical Association (JAMA) found that patients receiving PCC experienced better health outcomes and greater adherence to treatment plans, largely due to enhanced communication and shared decision-making between healthcare providers and patients.

Therefore, applying PCC results in:

• Improved patient satisfaction & wellbeing: When patients feel listened to and are part of the decision-making process, they are more likely to stick to treatment plans and feel empowered, coming from a place of satisfaction.
• Better clinical outcomes: By working together, doctors and patients can create personalised, effective treatments. This fosters better adherence to prescribed management and therefore reduces the risk of complications and failed treatment plans.
• Stronger doctor-patient relationships: Open communication builds trust, which fosters long-term partnerships and better overall care.
• Long-Term Support and Follow-Up: In my experience, trauma recovery is often a long-term process. PCC emphasises continuity of care, ensuring patients receive ongoing support and follow-up. This allows the healing journey to be monitored over time, with adjustments made as needed, providing consistent care throughout the recovery process and beyond clinical treatment.
• Emotional validation and compassion: PCC fosters compassionate, empathetic care, which is essential when treating individuals who have experienced trauma, as a cause to existing disease processes. Validating a patient’s emotional responses and creating a non-judgmental space can help them process their trauma in a safe and supportive way.
• Provider Satisfaction: It is not only about the patient; the well-being of health providers is equally important. Improved health outcomes lead to reduced readmissions and complications, which decrease patient lines from repeat visits. This enhances provider satisfaction through positive care outcomes. With reduced burnout, healthcare providers can find greater fulfillment in their work with less overwhelm. Patient-centered care (PCC) is truly a lifesaver in the clinical setting.

When dealing with trauma, integrating the principles of PCC greatly enhances recovery by offering a comprehensive, supportive, and individualised pathway to healing and wellness.

How then is PCC practiced and achieved?

At the core of quality medical practice, PCC means ensuring a patient feels heard, respected, and empowered throughout their health journey.

Here are some avenues to ensure that we achieve PCC

1. Thorough patient history & intake: Clinicians take the time to understand your medical history, lifestyle, and concerns. This helps them create a care plan that’s uniquely yours, specific to you and your context.
2. Active listening & clear explanations: Clinicians ensure that you not only feel heard but that you fully understand your health information and treatment options.
3. Shared decision-making tools: Visual aids like illustrations, images and diagrams, as well as decision tools, and individualised treatment options help us co-create a path to recovery that fits your own life, based on scientific evidence.
4. Open communication: You are encouraged to ask questions and foster a comfortable environment so as to speak freely and take ownership of your health decisions with clarity.

Patient-centered care is the future of healthcare, and it’s one where you take the lead. By partnering with your health care provider, you can improve your health outcomes, feel empowered, and build a relationship based on trust and communication.

However, in order to avoid misconceptions, while discussing PCC, it's important to clarify what it is not. PCC is not social work, nor is it merely about being "nice" to patients. It extends beyond simply having a good bedside manner or automatically meeting all of a patient's demands, which are distinct from addressing genuine concerns under the principles of medical ethics. PCC is not just an academic exercise that exists in theory without practical application.

Contrary to some beliefs, PCC does not necessarily take more time. With realistic time management, it can be seamlessly integrated into clinical practice, in any medical consultation, improving the quality of its outcomes.

Instead, PCC is a holistic and collaborative approach that focuses on actively involving patients in their care decisions, while fostering clear communication and respect for their values. PCC approaches promote wellness in the clinical space.

Clinicians have to be trained in PCC approaches as well as patients needing to be educated about what an ideal consultation ought to look like, as shown in this article.

This is a disclaimer: The information shared in this series is not intended for treatment purposes but to empower you with the knowledge and tools to take control of your health.

Sources:

1. Patient-centered care in Uganda: A critical analysis of implementation challenges. Source: PLOS ONE DOI: 10.1371/journal.pone.0256543
2. By John M. Kelley JM, The Influence of the Patient-Clinician Relationship on Healthcare Outcomes: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Strong Patient-Clinician Relationship and Improved Outcomes: Shared decision-making and open communication are critical to these results. (PLOS )
3. National Library Of Medicine: By Berntsen GR, et al. Person-centered care (PCC): the people's perspective. (NCBI. NLM. NIH )
4. Postgraduate Medical Journal: The Impact of PCC on Healthcare Costs and Patient Satisfaction - By Ami Schattner, Patients’ experience of care as key to improving quality of care (Oxford Academic )