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Getting from “Delivering Care to Patients” to “Partnership with Patients”

  • Alexander Blount
Chapter

Abstract

The IOM’s call for patients to be the source of control in their care has been represented differently at different times. The patient as the source of control has evolved from the clinician’s taking the patient’s preferences and values into account in designing care to a partnership between the clinician and the patient in making the choices necessary to plan care. This is a particularly challenging standard because both health professionals and many of their patients have been socialized to the model of the doctor leading care. Their difference in knowledge and in their perspective on the patient’s illness makes partnership difficult. This makes partnership challenging, even if the difference in levels of knowledge about the patient’s illness is reduced. Motivational interviewing, shared decision-making, minimally disruptive medicine, addressing health literacy, relationship-centered care, and coaching patients to be more assertive in relating to their physician, each of these approaches can be an important contribution, and each one demands extra attention and time to be effectively implemented. For some patients with particularly complex health situations, additional expertise on the part of the healthcare team is necessary to impact their health outcomes.

Keywords

Patient participation Healthcare reform Primary care Shared decision-making Minimally disruptive 

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Resources

    Patients Advocating for Patient Participation

    Health Literacy Resources

    1. From the Office of Disease Prevention and Health Promotion: https://health.gov/communication/literacy/quickguide/healthinfo.htm
    2. Chronic pain tools for patients with low reading levels. http://pmt.ua.edu/publications.html
    3. Agency for Healthcare Research and Quality health literacy toolkit for health systems. https://www.ahrq.gov/professionals/quality-patient-safety/quality-resources/tools/literacy-toolkit/index.html
    4. Videos on Culture and Health Literacy: https://www.thinkculturalhealth.hhs.gov/resources/videos
    5. Agency for Healthcare Quality and Research offers a guide for improving patient-provider communication https://www.ahrq.gov/professionals/systems/hospital/engagingfamilies/strategy2/index.html.

    Shared Decision-Making Resources

      For Professionals

      1. Ottawa Hospital Patient Decision Aides and the Healthwise Knowledgebase. https://decisionaid.ohri.ca/azinvent.php. The Healthwise Knowledgebase is intended for professional evaluation and not intended for distribution directly to patients or consumers.

      Decisional Aids for Patients

      1. https://shareddecisions.mayoclinic.org/. Mayo Clinic Shared Decision-Making National Resource Center. 1/27/18 offers tool kits for 8 conditions.
      2. Best access to multiple medical decision aids websites: http://www.dartmouth-hitchcock.org/supportive-services/patient-resources.html

    Minimally Disruptive Medicine

    1. Blog and connecting point for those interested—www.minimallydisruptivemedicine.org

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Alexander Blount
    • 1
  1. 1.Department of Clinical PsychologyAntioch University New EnglandKeeneUSA

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