Abstract
‘Patient-centeredness’ is a relatively new term in the medical lexicon. Yet it has become a mantra, expressed often and with little critical attention. For this reason, we might aspire to an ‘authentic’ patient-centeredness—as a patient-centeredness-to-come. And for this aspiration to become reality, we must shift medical culture from autocratic to democratic habits, to achieve a mutuality of care. Such mutuality in care benefits patients and so should be taught as an integral part of a medicine curriculum. However, first we must conceptualize ‘patient-centeredness’ as there are many varieties to this approach. I suggest a patient-centeredness without a centre, where mutually enhancing conversation is the ideal model. This recognizes both the doctor’s and the patient’s expertise within a narrative mode of care, with attention to, and tolerance of ‘difference’ as the key factor.
While expertise in the technical domain of clinical decision-making has been widely modelled, the non-technical domain of effective communication remains under-theorized and poorly modelled, but assumed. What is the nature of metacognitive clinical communication expertise and how might it be educated and ‘hothoused’ or accelerated?
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Bleakley, A. (2014). Patient-Centredness Without a Centre. In: Patient-Centred Medicine in Transition. Advances in Medical Education, vol 3. Springer, Cham. https://doi.org/10.1007/978-3-319-02487-5_4
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