Operationalizing person-centered medicine

2014 ◽  
Vol 2 (1) ◽  
pp. 98
Author(s):  
James Marcum ◽  
Jackson Griggs ◽  
Lauren Barron
Keyword(s):  
Clinical Practice ◽  
Evidence Based Medicine ◽  
Clinical Case ◽  
Patient Centered Care ◽  
Evidence Based ◽  
Patient Centered ◽  
Working Definition ◽  
Centered Care ◽  
Definition Of ◽  
Based Medicine

To recapture medicine’s “soul” for the “care” of patients, Miles and Mezzich propose a version of person-centered medicine in which they “coalesce” both evidence-based medicine and patient-centered care. To that end, they identify 5 key principles from which they formulate a 4-part working definition of person-centered medicine. In this paper, we first analyze philosophically -ontologically, epistemologically and ethically - both their principles and definition and we then present a clinical case to operationalize their notion of person-centered medicine. We conclude with a brief comment on its feasibility for modern clinical practice.

Evidence-based medicine offers an optimal starting point for person-centered medicine

2014 ◽  
Vol 2 (1) ◽  
pp. 76 ◽  
Author(s):  
Piet Post ◽  
Gordon Guyatt
Keyword(s):  
Decision Making ◽  
Evidence Based Medicine ◽  
Clinical Decision Making ◽  
Patient Centered Care ◽  
Evidence Based ◽  
Discussion Paper ◽  
Patient Centered ◽  
Starting Point ◽  
Centered Care ◽  
Based Medicine

In their discussion paper, Miles and Mezzich argue that evidence-based medicine (EBM) and patient-centered care have developed in parallel, but rarely have entered into exchange and dialogue. These authors emphasize the need for a rational form of integration to take part between EBM and patient-centered care. We agree wholeheartedly with the desirability of both dialogue and integration. The dialogue will be much less likely to be productive, however, when authors ignore or altogether misconstrue the evolution of evidence-based medicine and the recent work of EBM leaders. Statements claiming “a foundational irreconcilability between the fundamental principles of EBM and those of patient-centered care” are not likely to promote enthusiastic dialogue with the EBM community. In this commentary, we demonstrate that EBM has introduced and aggressively advocated for the integration of patient’s values and preferences in the process of clinical decision-making. Furthermore, EBM has highlighted the need for research into optimal ways of integrating patient values and preferences and, most recently, introduced and studied innovative ways of facilitating shared decision-making.

Is “scientifically informed, yet humanistic medicine” the solution to the crisis of modern medicine? A friendly corrective to the emergent model of Person-Centered Medicine

2014 ◽  
Vol 2 (1) ◽  
pp. 106 ◽  
Author(s):  
Maya Goldenberg
Keyword(s):  
Clinical Practice ◽  
Evidence Based Medicine ◽  
Modern Medicine ◽  
Evidence Based ◽  
Patient Centered ◽  
Centered Care ◽  
Model Evidence ◽  
Humanistic Medicine ◽  
Based Medicine ◽  
Conceptual Confusion

In Miles and Mezzich’s programmatic paper “The care of the patient and the soul of the clinic: person-centered medicine as an emergent model of modern clinical practice”, the authors draw from a wide variety of sources to frame a theoretical underpinning for the emerging concept of “person-centered medicine” as a model of clinical practice. The sources include humanistic and phenomenological medicine, the biopsychosocial model, evidence-based medicine, critics of evidence-based medicine and patient-centered care. Each offer commendable desiderata, which Miles and Mezzich selectively integrate into their burgeoning theoretical framework. My concern is that the selective uptake of desirably qualities from such diverse resources in order to progress person-centered medicine’s developing vision of “medicine for the person, by the person and with the person” obscures important theoretical differences among these sources that will likely result in difficulty for the concept of person-centered medicine. These diverse theoretical resources offer competing correctives to the problems with medicine. Some of these differences are irreconcilable and need to be highlighted in order to avoid creating conceptual confusion and allegiance to unproductive theoretical commitments at this critical point of framing and developing this emergent model of modern clinical practice. 

Evidence-Based Medicine in Otolaryngology Part XII: Assessing Patient Preferences

2020 ◽  
pp. 019459982095072
Author(s):  
Matthew R. Naunheim ◽  
Gregory W. Randolph ◽  
Jennifer J. Shin
Keyword(s):  
Clinical Practice ◽  
Medical Care ◽  
Patient Preferences ◽  
Evidence Based Medicine ◽  
Data Sources ◽  
Evidence Based ◽  
Patient Centered ◽  
Rigorous Evaluation ◽  
Current State ◽  
Based Medicine

Objective To provide a contemporary resource to update clinicians and researchers on the current state of assessment of patient preferences. Data Sources Published studies and literature regarding patient preferences, evidence-based practice, and patient-centered management in otolaryngology. Review Methods Patients make choices based on both physician input and their own preferences. These preferences are informed by personal values and attitudes, and they ideally result from a deliberative evaluation of the risks, benefits, and other outcomes pertaining to medical care. To date, rigorous evaluation of patient preferences for otolaryngologic conditions has not been integrated into clinical practice or research. This installment of the “Evidence-Based Medicine in Otolaryngology” series focuses on formal assessment of patient preferences and the optimal methods to determine them. Conclusions Methods have been developed to optimize our understanding of patient preferences. Implications for Practice Understanding these patient preferences may help promote an evidence-based approach to the care of individual patients.

Adaptive many model medicine trumps monocultural models: comment on the Miles and Mezzich emergent model of modern clinical practice

2014 ◽  
Vol 2 (1) ◽  
pp. 64
Author(s):  
Robin Nunn
Keyword(s):  
Evidence Based Medicine ◽  
Medical Model ◽  
Evidence Based ◽  
Multiple Perspectives ◽  
Single Model ◽  
Discussion Paper ◽  
Medical Problems ◽  
Patient Centered ◽  
Centered Care ◽  
Based Medicine

In their provocative and insightful discussion paper, Miles and Mezzich consider two parallel, but philosophically divergent movements in medicine: evidence-based medicine and patient-centered care. They call for the integration or coalescence of these contrasting movements into one model that "combines the strengths of both movements, but which dispenses with the weaknesses of each." I share their goal of placing the person at the center of medicine, rather than subordinating the person to the depersonalized science and technology represented by current models of evidence-based medicine. Yet I envision a person-centered model, indeed any medical model, not as an overriding unified entity, but rather as one component in a complex "many model medicine". I have tried to show elsewhere that the use of many models is likely to produce better outcomes than the dominance of any single model. Multiple models entail multiple perspectives and methods that may be necessary to solve difficult medical problems. This pluralistic view is consistent with Peabody's view, cited in the discussion paper, that medical art and science are not opposites, but are foundational components of medicine.

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