Jeff Rowe, Editor, Future Care

Jeff Rowe is the editor of Future Care and a veteran healthcare journalist and blogger who has reported extensively on initiatives to improve the healthcare system at the local, regional and national level.

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There's a lot of talk about putting patients at the center of the healthcare relationship, but patient advocates suggest providers need to listen better, too.

MAY 14, 2014 AT 6:11 PM

  

 

Evidence-based medicine is widely considered the gold standard of healthcare, but what constitutes "evidence?"

 

That, in a nutshell, is the question being asked by one British patient advocate, who noted recently that while "person-centered care" is very much a topic of many conversations, "much of the evidence, reporting and discussion about person-centered care continues to replicate (the) traditional model." That model, she says, "involves long established hierarchies and a power imbalance between those providing and those receiving care."

 

So what to do?

 

First, understand that shifting to person-centered care involves recognizing the limitations of quantitative evidence when it comes to getting a comprehensive set of medical answers concerning the condition of patients. "It is clearly a great format for some questions, and absolutely has a place," she says, "but it should be able to coexist with other forms of evidence and discussions. Increasingly, patients and others are publishing valuable thinking and resources that never reach a peer-reviewed journal."

 

Next, give patients access to the same articles physicians and researchers can review. "Open access to journals and other publications is becoming more common, and should be encouraged for articles with a direct relevance to patients."

 

Third, on a similar note, it might be time to revisit the traditional understanding of what's appropriate for peer-reviewed publications. "Do we need to think more broadly about what we mean by 'peer' to really justify that status? Any article or paper about health can count patients and (caregivers) within the catch-all of 'peers'."

 

This promises to be a long and complex conversation, but it's inevitable if healthcare providers and other stakeholders are serious about putting patients at the center of care. As she succinctly puts it, "The age-old dominance of quantitative professionally peer-reviewed reporting hasn't got a person anywhere near the centre, put there, imposed or otherwise."

 

Consequently, a significant step toward truly patient-centered care will involve accepting, in one form or another, the addition of qualitative evidence consisting of "patient reported measures, experiences and perspectives."

 

Put another way, if patients are supposed to be at the center of a provider's care, providers need to listen more thoroughly to what patients are saying.