Why hospitals and physicians should get serious about patient-centered care

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Source: Kevin MD

by STEVE WILKINS, MPH 

Health care professionals are a cynical lot.   We joke about the “fad or buzzword of the month,” usually some vague concept heralded by the powers on high.   Our job is to promote the idea, knowing full well that the “next big thing” is probably right around the corner.

Take “patient-centered.” It sure feels like a buzz word.   I suspect most hospital and physician executives, and their ad agency partners, would agree.  But this time things are very different.

Here are reasons why hospitals and physicians should get serious about patient-centered care.

1. Patients are starting to discover that their doctors and hospitals are not nearly as good as they should be.

“Pay no attention to that man behind the curtain.” This line comes from the Wizard of Oz where little Toto rips the curtain back to show the great and powerful Oz is merely an old medicine show marketer from Kansas.

The analogy is a good one.  Patients across the U.S., and other countries, are “doing a Toto” as they pull back the curtains on doctors and hospitals only to learn that they are often not getting the quality of care they expected.

People every day hear about some story that undermines their confidence in the health care system.  Doctor Smith at XYZ hospital amputated the wrong limb again, Sally down the street was given the wrong medication, Mr. Patel’s opinion was ignored by his doctor, and so on.  Unlike years past when such stories were infrequent and seemed to occur in some other city… stories now appear daily, occur in my city, and are instantly shared with people around the world via the internet.

2. Patient-centered care is the right thing to do, and it’s not that hard

I think most would agree that today’s health care system is still very provider-driven.  That means that the care that is delivered, how it is delivered, who delivers it, and how outcomes are measured are all defined from the providers’ perspective (physicians, hospitals and payers ).   Patient-centered care simply means looking at these same issues but from the perspective of individual patients.   Notice nowhere here did I equate patient-centered care with smile training, customer service training or pianos in attractive lobbies.  Patient-centered care means involving patients in the planning, delivery and evaluation of health care where it really counts in terms of outcomes, patient adherence, cost reduction and fewer re-hospitalizations.

Being patient-centered is like doing a market research study and then implementing the findings.  Patient-centered care does not give absolute control to patients, it simply invites them into the party and gives them a place at the table.  As providers, we don’t do a good job of listening to patients.  We do an even worse job when it comes to acting on what patients tell us they want.

3. Patient-centered care will make any hospital or doctor stand out from the crowd.

Like a beautiful rainbow, patients and providers will recognize patient-centered care when they see it.   Like rainbows, example of patient-centered care are few and far between, but here are some tell-tale signs:

• Providers and patients know each others’ names
• Patients’ opinions are actively sought, listened to and honored where possible (no, a suggestion box, patient satisfaction survey or mission statement constitute being patient-centered — if you think they are then you aren’t patient-centered)
• Patients tell you that their doctors and other team members really listened to what they had to say (again if you think satisfaction surveys qualify you aren’t there yet)
• Patients are treated as the most important member of their health care team and taught how they can best contribute to the team’s success
• Providers feel that their patients are actively involved in their own care
• You see a significant improvement in patient health status, adherence, engagement, level of utilization and patient/provider experience

If these aren’t good enough reasons to give patient-centered care another look at your organization then just think about this.  Beginning in 2013, 30% of hospital Medicare reimbursement will be determined based upon patient experience.  Eventually commercial payers will follow suit.

Steve Wilkins is a former hospital executive and consumer health behavior researcher who blogs atMind The Gap.

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