'Patient-centered care' too often means more marketing and falls short, health columnist says

Trudy Lieberman

"What passes for patient-centered care falls short" many times, Trudy Lieberman writes for the Rural Health News Service. She tells some stories, including that of a Nebraska man whose post-surgery cancer treatments were delayed two months because someone messed up at the local hospital he wanted to use. “He is so angry. We are so angry,” the man's daughter told Lieberman. “So much for urgency and professionalism.”

Another patient had difficulty getting diabetic supplies, including "pens used to inject insulin," Lieberman reports. "He ordered them and approved the charge to his credit card using a telephone automated order system. Several days later the supplier called and left a message asking him to confirm the shipment. When he called back, he learned the cost exceeded the limit for automatic approvals, and the order wouldn’t be processed until he personally approved the charge. No one had told him there was a limit. So much time had passed that he had only a two-day of supply of insulin left." The man told Lieberman, “The delay created a potential emergency.”

It got worse, Lieberman writes: "Often patient engagement has come to mean selling things, particularly tools and devices, that purport to help patients manage their care. During the man’s many calls with the supplier the company tried to sell him knee and back braces, advising that Medicare would pay if he got a doctor’s prescription." And she gives other examples of medical marketing.

Patient-centered care is a "buzz phrase that’s all the rage in health-care circles," Lieberman writes. "It goes by a lot of different names like patient engagement, patient activation, and shared-decision making. If care is truly patient-centered, it revolves around eight principles identified in research by the Harvard Medical School and the Picker Institute. They include respect for patient preferences, coordination of care, information and education, physical comfort, emotional support, involvement of family and friends, continuity and transition, and access to care."