Five Ways to Tell If Your Physician Is Patient Centered

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Hint- Being Designated As A Patient Centered Medical Home Is Not One

We hear a lot about patient centered care these days.  In particular, a growing number of physicians across the country are now referring to their practices as a Patient Centered Medical Home.

But how can you tell if your physician’s practice really is patient centered no matter what he or she may call them self?   More importantly, why should you care?

What is patient center care you ask?  It’s is quality care delivered in a manner where you feel that your provider:

  • Knows who you are personally as well as clinically
  • Understands, respects and honors (where practicable) your previous health experiences, beliefs and preferences
  • Facilitates and supports your health choices and behavior barring a serious conflict of beliefs or principles

Since each of us possess a different set of experiences, beliefs and preferences, patient centered care by definition is tailored to individual patients.   For example, some patients like their doctor to take charge and make the important decisions.   Other patients may want to be the one in charge, while others still may prefer a more collaborative style.  Ideally a patient centered physician knows where the patient is coming from and does his or her best to accommodate the patient.    Why?  Because patient center care, where the patients feels understood, listened to and respected, results in increased patient compliance, improved health status and better outcomes.

Five Ways to Tell If Your Physician Is Patient Centered

  1. Your doctor asks you up front “what brings you in to see me today” and then let’s you answer the question without interruption.   In other words your doctor is a good listener.
  2. Your doctor asks you for your thoughts regarding the cause of a health concern, as well as any thoughts you may have for how to deal with a particular concern?
  3. You feel like you can talk to your doctor about your interest in seeing a chiropractor or acupuncturist without fear of ridicule.
  4. Your doctor does not “default” to prescribing a medication knowing full well you don’t like taking medication.
  5. Your doctor asks you about other aspects of your life (family, work, social) that may serve as context for  making the best treatment recommendations.

It may be helpful to understand what patient centered care is not, at least for some people.   Remember it can be different for each patient.

Patient centered is not necessarily about being designated as a Medical Home, having electronic medical records, offering e-mail visits, group visits, or collaborative care, although it may be for some patients.  Nor is all about collaborative care planning, joint decision making or team care.   Again, different strokes for different folks.

Why should you pay attention to which physicians are patient centered and who are not?

There are many reasons, but first and foremost, you are more likely to get  appropriate (e.g., better) care, tailored to your beliefs and preferences.   Odds are you will have a much more satisfactory health experience and will be more likely to follow your doctor’s recommendations.  After all you helped come up with them.

Warning!

Be very suspicious when you come across providers or hospitals calling themselves “patient centered.”  If you want to have some fun, ask them what they mean by patient centered.   If they say it is because “we put the patient first” you know they haven’t a clue and are just using it as a marketing ploy.

Do yourself a favor and run for your life!!

9 Comments

  1. Agree that many ‘words’ are used without true meaning. Dorland Health, the publisher of Case In Point, a national publication for those who coordinate care for patients will hold a one day summit on Oct 5th, 2010 in Washington DC. The title of the program is the Care Coordination Summit: Improving Practice in a Time of Change. http://www.dorlandhealth.com/Care-Summit/care-summit.html

    Hope to see you there…Anne Llewellyn, RN-BC, MS, BHSA, CCM, CRRN

  2. Bob Stone says:

    For the more than 50 % of us who are female, the first tip-off is whether or not the physician, after listening to the patient explain why she’s there asks, “Are you experiencing a lot of stress.” I don’t know where int he medical school curriculum budding physicians are taught that the root of all illness for females is their stress level, but the near ubiquity with which this question is asked — even by female physicians — is the first clue that they don’t have a clue. Don’t take my word for it; ask my wife!

    • Stephen Wilkins says:

      Excellent point! Yet these same doctors are totally oblivious to the stress and other health challenges faced by the unemployed man or woman sitting in their wait rooms. Health occurs within the greater context of each of our lives and doctors seldom time exploring that context.

    • Amy says:

      Totally agree! As a woman, I’ve gone to a doctor one too many times with a legitimate physical symptom and had them ask a question like he’s hoping he can pathologize it with a psychological diagnosis. Most recently I went to primary care because of repeated bouts of terrible ear pain. Naturally, the constant pain was wearing on me, but I certainly had no mental health problems. He suggested I see someone for stress!

      So I went to another doctor who diagnosed me with a bad inner ear infection, gave me a course of antibiotics and pain medication, and sent me home. I felt better within a couple days.

  3. Lauren Wilcox says:

    Nice insights.

    A couple of additional questions that I ask when evaluating patient-centered approaches:

    1. Does my doctor make sure I understand everything that happened today: either through verbal explanations, or by pointing me to very good resources that I can access easily?

    2. Is the care process transparent? E.g., can I see the same data that my doctor sees? Same images? How easy is it, in practice, to get copies of this info?

    • Stephen Wilkins says:

      Great comments. You are absolutely right about the value of verifying what the patient “has heard” during the appointment. If the patient wants to see their medical record or physician notes that should be their right…not a privilege. I’d be interested in knowing how many people would ask for that right given the low level of involvement of many during the typical office visit.

  4. Thank you for shedding light on patient-centered care from the patient’s perspective. Your pointers are excellent and we want to be sure you and your readers know about our organization and website – The Empowered Patient Coalition. We work to place excellent and practical resources into the hands of patients and advocates so they will have the knowledge and the confidence to ask questions and voice their concerns and ideas about their care. Patient-centered care strives to put the patient at the center of the health care team, but this will never happen unless the patient has some basic information and skills to truly participate. Thanks again for this post.

    Regards,
    Julia Hallisy
    The Empowered Patient Coalition
    http://www.EmpoweredPatientCoalition.org

  5. http://onlinelibrary.wiley.com/doi/10.1111/j.1475-6773.2010.01212.x/abstract
    This article is completely wrong about what the criteria are for the patient cented medical home. It lists health indicators as criterion and not patient values, communication or any of the core care coordination measures, it does not define patient centered teams or care coordination issuses

    • Rebecca,

      Thanks for your feedback. Actually the post your are referring does not speak to Patient Centered Medical Homes (PCMH) so much as it attempts to define what patient center care is…and how patients can recognize it when they see it.

      One should avoid confusing the patient centered care (the concept) with the Patient Centered Medical Home (the care delivery model). Many providers deliver patient centered care and yet do not qualify as a medical home. I would argue that there is nothing very patient centered about the way many of the on-going medical home pilots which are more concerned with IT and teams than listening to their patients.

      You may be interested in reading the following article by Don Berwick, MD., What ‘Patient-Centered’ Should Mean: Confessions Of An Extremist. Health Affairs. 2009 vol. 28 no. 4.

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