Educational program “Communication in the Treatment Process” – description, goals, and theoretical background

Effective medical communication is an extremely important aspect of patient-centered medicine. It allows for achieving better treatment outcomes and is of key importance in the case of patients experiencing mental problems. Research clearly indicates that the quality of communication is a fundamental element of medical services, which not only affects patient satisfaction, but can also reduce the risk of burnout among staff who have contact with patients. A sense of mutual understanding translates into trust and contributes to more conscientious adherence to medical recommendations. Considering the cooperation of all medical and non-medical personnel, high-quality communication reduces the risk of tensions and conflicts, as well as the number of complaints reported by patients. Both research findings and our own experience show that individuals with mental disorders often feel misunderstood, stigmatised, or ignored by healthcare personnel. Based on the above assumptions, the experts from Józef Babiński Specialist Hospital in Kraków developed their own program entitled “Communication in the Treatment Process.” It was implemented in 2018 by the Ministry of Health among over 2,500 professionals in the Małopolskie and Podkarpackie provinces. The aim of the project was to improve the communication skills of medical and non-medical personnel in the context of communication with patients with mental disorders. The paper describes in detail the theoretical background, the goals, and the course of the program.

Exploring the Relationship between Shared Decision-Making, Patient-Centered Medicine, and Evidence-Based Medicine

Shared decision-making is a possible link between the best of patient-centered medicine and evidence-based medicine. This article seeks to describe the link between them. It discusses to what extent the integration of such perspectives is successful in assuring respect for the patient’s autonomy. From the evidence herein, we conclude that if the doctor–patient relationship and communication are strengthened to cover all issues relevant to the patient’s health and values, is it possible for him or her to achieve more autonomous decisions by this linkage of shared decision-making and patient-centered medicine? Summary: Shared decision-making is a possible link between the best of patient-centered medicine and evidence-based medicine. This article seeks to describe the link between them.

Patient-Centered Medicine: A Necessary Condition for the Management of Functional Somatic Syndromes and Bodily Distress

This paper argues that “functional,” “medically unexplained,” or “somatoform” symptoms and disorders necessarily require a patient-centered approach from the clinicians. In the first part, I address the multiple causes of the patients' suffering and I analyze the unease of the doctors faced with these disorders. I emphasize the iatrogenic role of medical investigations and the frequent failure in attempting to reassure the patients. I stress the difficulties in finding the right terms and concepts, despite overabundant nosological categories, to give a full account of psychosomatic complexity. Finally, I discuss the moral dimension attached to assigning a symptom, at times arbitrarily, to a psychogenic origin. The following part presents a brief reminder of the patient-centered approach (PCA) in medicine. In the last part, I aim to explain why and how patient-centered medicine should be applied in the context of functional disorders. First, because PCA focuses on the patients' experience of illness rather than the disease from the medical point of view, which is, indeed, absent. Second, because PCA is the only way to avoid sterile attribution conflicts. Last, because PCA allows doctors and patients to collaboratively create plausible and non-stigmatizing explanations for the symptoms, which paves the way toward effective management.

Patient and Employee Experiences in Healthcare: Research Insights

Experiences drive loyalty, satisfaction, and advocacy, and the experiences that patients, caregivers, and employees in healthcare can be explicitly measured and correlated with important outcomes for the industry and the organizations that deliver care. As the industry strives to embrace patient-centered medicine, especially now in complex times, experiences are being tested and are more important than ever to realize improved patient quality of care and employee focus on patient outcomes. In addition to the findings of our research in patient and employee experience, this paper highlights insights from other industries that can be leveraged in healthcare to set a new bar in experiences that drive the outcomes that matter.

Integrating Comorbidities and Phenotype-Based Medicine in Patient-Centered Medicine in COPD

Despite recent notable innovations in the management of chronic obstructive pulmonary disease (COPD), no major advances in patient-centered medicine have been achieved. Current guidelines base their proposals on the average results from clinical trials, leading to what could be termed ‘means-based’ medical practice. However, the therapeutic response is variable at the patient level. Additionally, the variability of the clinical presentation interacts with comorbidities to form a complex clinical scenario for clinicians to deal with. Consequently, no consensus has been reached over a practical approach for combining comorbidities and disease presentation markers in the therapeutic algorithm. In this context, from the patients’ first visit, the clinician faces four major dilemmas: (1) establishing the correct diagnosis of COPD as opposed to other airway diseases, such as bronchial asthma; (2) deciding on the initial therapeutic approach based on the clinical characteristics of each case; (3) setting up a study strategy for non-responding patients; (4) pursuing a follow-up strategy with two well-defined periods according to whether close or long-term follow-up is required. Here, we will address these major dilemmas in the search for a patient-centered approach to COPD management and suggest how to combine them all in a single easy-to-use strategy.

MEDICAL PROFESSIONALISM AND ETHICAL AND HUMAN RIGHTS FOUNDATIONS OF PERSON-CENTERED MEDICINE

Person-centered medicine (PCM) is a concept that has gained increased acceptance, being a broader term than patient-centered medicine. With PCM the whole of a person is taken into consideration, whether healthy or in disease as well as his or her family. The person of the health professional is also incorporated in this concept. In this article, ethical background to person-centeredness in universal declarations and some international central policies are addressed. Primarily, the UN Universal Declaration on Human Rights (UDHR) will be discussed as well as official policy documents of the World Medical Association (WMA). Lastly, the content of a WMA Declaration on Medical Professionalism are discussed.

From patient-centered medicine to 4p-medicine: the semantic aspect of the trend

The step-by-step guidelines for the formation, development and implementation of the direction defined as “patient-oriented medicine” in the scientific and practical segments of healthcare are presented. It reflects not only the historical aspect of this semantic plot, but also gives a characteristic of the diverse models of interaction between subjects – a doctor and a patient. The analysis of definitions of “patient-oriented medicine” in the framework of foreign and domestic scientific schools, as well as the analysis of the relationship of the pattern with the new concept of health care development – 4P-medicine is given. The structure of the 4R-medicine concept is characterized, the ideological implications of the prospects for its development are given. The legislative and organizational initiatives for the development of patient-oriented medicine are outlined.