Patient-Centered Healthcare: A Story To Be Told

I was having a discussion with one of my mentors, Dr. Larry Chan, yesterday. If you know Dr. Chan, he has an ability to captivate you with a story while he works. Before you know it, you’re healed, it’s been 30 years since you have been better but you still come back to hear his stories.

There is something to be said about the relationship of a doctor and a patient. The time shared behind the closed doors of a medical office are more than just the tests that are run, the procedures performed, and the medicines prescribed. The relationship itself between a doctor and a patient is medicine, and maybe the most complex and intricate part of a practice.

Disease-Centered vs. Patient-Centered Healthcare

Modern medicine has been a marvel in addressing acute and infectious disease processes. The current medical model is founded on the purpose of defining, targeting and eradicating illness. Advances in technology, molecular biology, surgery, and pharmaceuticals are the Atlases on which modern medicine pivots on and has taken humans out of the dark ages of illness.

As the era of the infectious disease eclipses, the emergence of chronic illness becomes our new plague. Cancer, cardiovascular disease, stroke, respiratory disease, and diabetes are by far the leading causes of mortality in the world representing 63% of all deaths (1). This new generation of illness has a complexity of factors that contribute to their manifestation and require more than just a disease eradicating approach.

Chronic conditions, though vast in their clinical differences all have a spectrum of similar needs: to alter the behavior of the patient, to deal with social and emotional impacts of symptoms, disabilities, and approaching death, to take medicines, and to interact with medical care over time (2).Patient centered care is a philosophy of medicine which incorporates the patient’s preferences, and individual needs to the care provided by a health practitioner and ensures that the patient’s values guide all clinical decisions (3).

It not only empowers people to take part in their own health, which influence more than just how a person develops a disease, but patient centered care provides the therapeutic space to more effectively combat the complexities that chronic disease pose.

What Works

There is a growing body of evidence that supports patient centered care as an effective approach to multi-factorial illnesses. A quantitative research paper on a population of New Zealand patients with diabetes in 2014 looked at patient centered approach to care in management of the disease. They found that this method ultimately assists in long-term reduction and management of diabetes (4).

Not only that, but it reduced the overall cost of care per patient as well as improved sustained compliance for treatment. Because patients had variability in expectations, education, language, genetics and other lifestyle differences, researchers found by focusing on how to address differences in patients instead of treating just the disease overall outcomes were better.

Furthermore it stimulates the healing power of the patient and allows people to be interactive and more involved in their own healthcare. This has posed a massive hurdle in medicine. A large component of the emergence of chronic illness is lifestyle behavior. When addressing lifestyle change it must come from the patient themselves and bolstered by external forces.

As medical practitioners I think it’s important to guide patients with their own will to heal; this is the most sustainable way to health and wellness. Which brings us full circle, Dr. Larry Chan tells stories. Inside his mind, I’m sure, lies a trove of tales.

And what I’ve noticed as a newly appointed padawan in Jedi training is that it’s a tool; a tool that sits in his medicine bag along with acupuncture needles, herbs, and a stethoscope. It arguably is the most important tool, because it is a way to build and strengthen a relationship, and as such telling stories may be the most potent medicine we have.