Patient-Focused Care

Patient-Focused CarePatient-focused or patient-centered care is not a new concept, but its value has been overlooked in preference to the physician-led, technology-based, disease-centered model that has prevailed in medicine for the last 50 years. Stewart suggests that patient-focused care is often defined by what it is not: technology centered, doctor centered, hospital centered, and disease centered. Today, patient-focused care can be thought of as a merging of the patient education, self-care, and evidence-based models of medical practice. Patient-focused care takes the best points from each of these models and distills them into four broad areas of intervention: communication with patients, partnerships, health promotion, and physical care (medications and treatments). Patient-focused care, therefore, requires an appreciation of a variety of issues: patients’ expectations, beliefs, and concerns regarding their disease and an understanding of their personal circumstances; the motivation to provide information regarding diagnosis, pathology, treatments, and prognosis; the ability to find a common ground on what the problem is and agreeing on management; and the knowledge to utilize the best medical evidence to inform treatment decisions.

The relative importance of different areas of patient-focused care and how they can be enacted have been debated. Also, clear distinctions have been made between “partnership” and “shared decision making”—the latter being one approach of many to achieving the former. Putting aside semantic debates on the definition of patient-focused care, it is perhaps easier to conceptualize it as being the care we would like our loved ones to receive. This article reviews some of the evidence to support patient preferences for patient-focused care, examines the reasons that might have impaired the widespread teaching and adoption of this approach, and outlines some of the potential benefits of patient-focused care for both physicians and patients, with particular reference to asthma management,

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