The Health Care System’s Commitment to Patient-Centered Care
By Kara Gainer
Over the last several decades, the phrase “patient-centered care” has grown in popularity. Patient-centered care places the focus on the patient, as opposed to the physician. The Institute of Medicine (IOM) defines patient-centered care as “providing care that is respectful of and responsive to individual patient preferences, needs, and values, and ensuring that patient values guide all clinical decisions.” The IOM separates patient-centered care into eight dimensions, including respect, coordination of care, emotional support, physical comfort, involvement of the family, continuity and transition and access to care.
The term patient-centered care originated in the 1960s and was first utilized by psychiatrists in the United Kingdom who were training medical students to focus their attention on patients’ emotions. In the United States, a focus on patient-centered care was initially utilized as a means to evaluate inpatient hospital stays.
Today, various types of health care institutions are striving to deliver patient-centered care in response to research showing greater patient satisfaction and more efficient use of resources under the approach. But what does patient-centered care actually look like in practice? Generally, patient-centered care places an emphasis on coordinated and integrated interactions between the patient and clinician, including open communication and shared decision-making, which ensures the patient is an active participant in his or her care; treating the patient with dignity and respect; and involving the family and caregivers in decision-making.
According to the Commonwealth Fund, “the extent to which patients and their families are involved in making decisions and feel prepared to manage their conditions is critical to improving quality and reducing cost.” The results of studies show that clinicians who are poor communicators with their patients tend to increase the utilization of tests and other medical care to make up for the lack of communication. Such findings support the notion that improving patient-centered communication can increase efficiency of care and reduce costs, not only through fewer tests but also through fewer repeat hospitalizations and referrals to specialty care. Moreover, the extent to which a patient perceives that his or her care has been patient-centered has been found to be associated with greater satisfaction and reduced symptom burden.
Providers are increasingly being encouraged to take into consideration patient needs, preferences, and treatment goals in the delivery of care. Just recently, CMS released the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) implementation final rule, which offers financial incentives for Medicare clinicians to deliver high-quality, patient-centered care. By taking the time to learn the patient’s goals and treatment preferences, not only will the patient walk away from the medical treatment or service feeling understood and cared for by the provider, but it will also result in a better, more comprehensive plan of care. Policymakers are hopeful that the new incentive-based payment system will accelerate improvement efforts.
Athletic trainers (ATs) have a unique perspective to lend to patient-centered care efforts. ATs often face conflicting pressures from patients, coaches, family members and others when it comes to care decisions. However, if the modern emphasis on patient centeredness continues to grow, ATs and their supervising physicians may be able to leverage increased public appreciation for the concept to negotiate better care decisions with the patient’s best interest in mind.