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Letting the Patient Call the Shots

Editor’s note: Don Berwick is one of the titans of systems thinking in health care. We should pay attention to what he says. He has started, many successful initiatives including the 100,000 Lives Campaign to save a 100,000 lives in hospitals. He got hospitals to sign up for the effort in droves and got them to deliver measurable results. 

But a couple of weeks ago, Dr. Donald M. Berwick, made me wonder if I should do more.

Dr. Berwick, a Harvard pediatrician and president of the Institute for Healthcare Improvement in Cambridge, Mass., is a leading authority on health care quality. Last month in a national health policy journal, Dr. Berwick published an article titled, “What ’Patient-Centered’ Should Mean: Confessions of an Extremist.” In it, he writes that the United States will require health care systems that are radically different from most of the ones we have today if we are to deliver truly patient-centered care. These systems would transfer control from doctors to the patients themselves.

Some examples of this new model of care? Shared decision-making would be mandatory in all areas of care, with patient preference occasionally putting evidence-based care “in the back seat.” Patients and families would participate in the design of health care processes and services and would be a part of daily rounds. Medical records would belong not to clinicians but to patients, who would no longer have to get permission to look at them or call the doctor for lab results.

Even the word “compliance” would become obsolete.

As Dr. Berwick writes in his piece, “[We] would all be far better off if we professsionals recalibrated our work such that we behaved with patients and families not as hosts in the care system, but as guests in their lives.”

I called Dr. Berwick recently to discuss his definition of patient-centered health care, the effect of such a system on doctors, and actions patients could take now to improve their care.

http://www.nytimes.com/2009/06/04/health/04chen.html?_r=1&hpw

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June 4, 2009 - Posted by | Accountability, Health care delivery, healthcare | , , , , , , ,

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