Patient-centered care


#1

This came from the American Diabetes Association press release that accompanied the release of the 2019 Standards of Care.

With the evidence from the latest, high-quality diabetes research, the American Diabetes Association’s 2019 Standards of Medical Care in Diabetes (Standards of Care) include new and revised clinical practice recommendations that put the patient at the center of care.

This use of the term, “patient-centered care” can be found in almost any health organization or hospital public communication these days. I guess the health care business is not different than any business sector these days. They all have an evolving body of lingo intended to communicate their mission.

As a patient with a chronic diseases and frequent user of health products and services, I find this term disingenuous. I don’t have a problem with the sentiment itself. I like that our doctors, hospitals, and suppliers assert that the patient should be the focus of all their efforts. But is this the reality?

Consider the ADA Standards of Care. It serves a valuable purpose to communicate to all diabetes practitioners about the best current way to treat diabetes. The term, “patient-centered care” is mentioned 15 times throughout the document.

I get the distinct impression from reading this document that what’s been published is what the medical writers think is good for us. I see nowhere in this publication any effort to survey or in any way capture what the patient thinks or prefers. They make the implied assertion that what the doctors think serves the patient well is actually what the patients want as well.

While I know that the doctors interest for us has a lot of overlap with what is actually good for us, I don’t think that our interests are 100% congruent. Perhaps this is making too fine of a semantic point but I think if they’re going to talk about what’s good for us, they would at least make a reasonable effort to ask us. The lack of this effort to ask the patient just tells me that their view of what they think the patient wants is the only one that matters.

Anyone else tired of the misuse of this cliche? Is patient-centered care about the patient’s interest or the doctors’ perception of the patient’s interest? It’s not the same thing.


#2

I think it’s simply another attempt at medical obfuscation to cover what has always been a “godlike attitude” taken by the medical profession. “We are here to serve the patient but we know what is best and the patient should comply.”

That is the reason I stay as far away from doctors as I can and see a female CDE NP for my diabetes care. She writes the Rxs and I named her as my primary practitioner for my health insurance. Our contact is brief and complies with the Medicare required 4 times a year. She leaves control to me and only makes suggestions if and when asked, which hasn’t happened yet.

Do you detect hostility towards the medical profession? Absolutely!


#3

Patronizing is the word I held back from using in the original post.

I once told an endo that I was attending a diabetes conference. I volunteered that when patients got together at these conferences, we talked about our doctors!


#4

But did you tell him what was said when you talked about your doctors? :hushed:


#5

I guess I have been extremely fortunate, because I have only had one GP who has given me any problem at all. She was young and by the book and insisted that my A1C was way too low. It was 4.9 and she wanted it at 6.5. She also didn’t like the fact that I was a very low carber. This was about 10 yrs ago. She insisted I go to a diabetologist she knew to see what he thought. He agreed with me. She still wasn’t happy, so I changed doctors,

My present doc follows my lead about how I treat my health. When I have needed surgery, I am firm with the doctors and nurses and they follow my lead, unless I am not well versed on the procedure. I try to be respectful.

I had a nurse at the hopital who looked at my records and said that I needed 100 units of humolog before meals. I needed 1 unit. She could have killed me, if I hadn’t corrected her. I also try to always have my husband with me, so that the two of us make my needs known.

I haven’t had a procedure done since 2010, so I don’t know what I could be facing in the hospital these days.

Oh wait, I had another GP about 3 yrs ago, who was patronizing, I dropped her after 3 visits. Also since I have been a type 1 for so long, most of the medical people figure I know what I am doing.

I am very fortunate that I have very good insurance, so I can change doctors if I feel that they are going to harm me.

I am strongly for socialized medicine, but don’t know what I would do if I had a misinformed doctor,or a pompous jerk and couldn’t change doctors.