Seeking the Person at the Center of Medicine

Description

It has become clear that reductionist models of health care are unsustainable in both economic and humanistic terms. There is a pressing need, therefore, articulated increasingly by patients themselves, to move away from impersonal, fragmented and decontextualized systems of healthcare towards personalized, integrated and contextualised models of clinical practice within a humanistic framework of care that recognizes the importance of applying science in a manner which respects the patient as a whole person and takes full account of his values, preferences, aspirations stories, cultural context, fears, worries and hopes and which thus recognizes and responds to his emotional, social and spiritual necessities in addition to his physical needs.

The Educational Program for Person-centered Care aims to achieve this. It is divided into three discrete but interrelated sections. The first section of four papers includes the conceptualization and measurement in person centered medicine and embraces the relevance of the social determinants of health and people centered public health. The second group of articles moves on to the practical aspects of patient-physician communication and the importance of a comprehensive diagnosis. The third section emphasizes the importance of shared decision making with key examples and inter-professional collaboration. The program is a living document and will be revised with the help of those who study and apply a person-centered approach to their own practice.

Sujets

• Médecine
• Médecine Générale
• Health Policy
• Essays
• Medical
• Health care system
• Research
• Administration

Informations

• Publié par: Legend Press
• Date de parution: 22 novembre 2021
• Nombre de lectures: 0
• EAN13: 9781915054630
• Langue: English

Extrait

International College of Person Centered Medicine
Educational Program on Person Centered Care
Print ISBN: 9781915054623
E-book ISBN: 9781915054630
Set in Times, Printed by Lightning Source UK
First Edition: 2021
The University of Buckingham Press Limited 2021
Published by The University of Buckingham Press
51 Gower Street, London WC1E 6HJ
Unless otherwise stated, the opinions expressed by the authors of articles are their own, and do not represent the views of the Publisher.
All rights reserved. No part of this publication may be reproduced, stored in or introduced into a retrieval system, or transmitted, in any form, or by any means electronic, mechanical, photocopying, recording or otherwise, without the prior permission of the publisher. Any person who commits any unauthorised act in relation to this publication may be liable to criminal prosecution and civil claims for damages.
CONTENTS
FOREWORD
W. James Appleyard and Juan E. Mezzich
PREFACE
Ahmed Thuwaini Al-Enizi and Salem Ali Al-Kandari
SECTION 1
General Concepts and Organization
Introduction to Section 1
W. James Appleyard and Juan E. Mezzich
1.1 Person Centered Medicine Foundations for Medical Education
Juan E. Mezzich, Ihsan Salloum, Levent Kirisci, Alberto Perales
1.2 Medical Professionalism and Ethical and Human Rights Foundations of Person Centered Medicine
Jon Snaedal
1.3 The Making of a Physician: A Person-Centered Approach
Shridhar Sharma, Gautam Sharma
1.4 Concepts and Strategies of People-Centered Public Health
Fredy A. Canchihuaman, W. James Appleyard, Juan E. Mezzich
SECTION 2
Communication, Common Ground, Diagnosis, and Assessment
Introduction to Section 2
W. James Appleyard and Juan E. Mezzich
2.1 Communication And Empathy Within Person-Centered Medicine: A Developmental Point Of View
Michel Botbol
2.2 Setting a Common Ground for Collaborative Care and Clinical Interviewing
Juan E. Mezzich
2.3 Person-centered Integrative Diagnosis: Concepts and Procedures
Ihsan Salloum and Juan E. Mezzich
2.4 Continuity and Integration of Person Centered Assessment and Care Across the Lifecycle
W. James Appleyard and Michel Botbol
SECTION 3
Care Planning, Shared Decision Making and Inter-Professional Collaboration
Introduction to Section 3
W. James Appleyard and Juan E. Mezzich
3.1 Person-centered Care Planning and Shared Decision-making for Mental and Comorbid Conditions:
Helen Millar
3.2 Shared Decision Making in Oncology and Palliative Care:
Paul Glare
3.3 Shared Decision Making for Other General Conditions:
W. James Appleyard and Jon Snaedal
3.4 Inter-professional Collaboration
Tesfa Ghebrehiwet
FOREWORD
As an introduction to this monograph presenting the Educational Program on Person Centered Care from the International College of Person Centered Medicine we would like to list the following objectives of the Program. They have evolved through annual Geneva Conferences and International Congresses 1, 2 .
1. To recognise the centrality of the individual person in medical practice and the need for a person and people centred approach to health care.
2. To understand the principles underlying person centred medicine and address strategies and procedures for person-centered care in terms of knowledge, skills and attitudes.
3. To develop skills and attitudes for the person-centered management of clinical problems and health promotion.
4. To understand how the principles underlying person centred care can be renewed in everyday clinical practice for the promotion of wellbeing and within an integrated multi- professional management of Illness.
5. To develop a flexible plan for the implementation, monitoring, evaluation and revision of the educational program.
The person has always been in the center of medicine and medical developments but in the language in current use of patients involved in healthcare Individuals are labelled in different ways which are descriptive not of a person but of a relationship and likely never will reflect the wide diversity of each individual. That is why the prefix person centered has become so important.
Historically early communities were simple and skills and knowledge were basic. With a sick person those around waited and watched for a resolution of illness and probably comforted others when they could others. With few therapeutic measures available, magical healing as accompaniment by the medicine man and the family became key features.
The mutation into a physician depended on observation, the accumulation of knowledge, records and eventually the development of a structure within society with apprenticeship, centres of learning and places where treatment could be delivered by specialists. Trade Guilds emerged which controlled the way in which physicians were able to practice.
The torch of medical learning was not passed on smoothly like a relay baton but with the emergence of Islam in 7th Century CE, Greek and Roman texts were translated into Arabic, incorporating the wisdom and practices from many centuries and from many civilizations stretching Westward from China. Physicians such as Haroon Al Rashid, Rhazes and Avicenna residing in Bagdad were prominent in the Eastern Arab Caliphate between 766 and 1,037CE.
The Islamic invasion of the Iberian Peninsula in 711CE took this wealth of knowledge to Northern Europe. Physicians who emerged here and flourished included Avenzoar and Maimonides. European medicine was therefore led out of the Dark Ages as a result of communication with the Arab world. Europe continued to benefit enormously from the wealth of medical knowledge brought by Islam via Spain. Therapies not practised in Europe and a knowledge of herbal medicine was part of this legacy. In addition, the Arab influence left behind important principles of care such as that of incorporating centres of treatment into communities with Barristan s courtyards with medical facilities as well as places of commerce and refuge. Many of their traditional principles in the delivery of care such as holistic treatment, specialist units, outreach home visits, annual accreditation, multi-professional care and a minimum of religious control are being refreshed by the person centered movement.
Evolving in parallel with person-centered care, evidence-based medicine arrived as a new approach to teaching the practice of medicine, advanced as the new paradigm for medical practice. It de-emphasized intuition, unsystematic clinical experience and pathophysiology as adequate grounds for clinical decision-making, recommending instead the use of purely scientific evidence. However, it is the person as a patient who must exercise the final choice. Thus, a healthcare system which mandates the use of rigid evidence-based guidelines has the potential to lead directly to a misaligning of the goals of doctors and patients .
It has become clear that reductionist models of health care are unsustainable in both economic and humanistic terms. There is a pressing need, therefore, articulated increasingly by patients themselves, to move away from impersonal, fragmented and decontextualized systems of healthcare towards personalized, integrated and contextualised models of clinical practice within a humanistic framework of care that recognizes the importance of applying science in a manner which respects the patient as a whole person and takes full account of his values, preferences, aspirations stories, cultural context, fears, worries and hopes and which thus recognizes and responds to his emotional, social and spiritual necessities in addition to his physical needs.
The Educational Program for Person-centered Care aims to achieve this. It is divided into three discrete but interrelated sections. The first section of four papers includes the conceptualization and measurement in person centered medicine and embraces the relevance of the social determinants of health and people centered public health. The second group of articles moves on to the practical aspects of patient-physician communication and the importance of a comprehensive diagnosis. The third section emphasizes the importance of shared decision making with key examples and inter-professional collaboration. The program is a living document and will be revised with the help of those who study and apply a personcentered approach to their own practice.
W. James Appleyard and Juan E. Mezzich, Editors.
REFERENCES
1. ICPCM. Zagreb Declaration 2013 on Person-centered Professional Education. Int J Person Centered Medicine 4: 6-7, 2014.
2. ICPCM. Madrid Declaration 2016 on Medical Education and the Goals of Health Care. Int J Person Centered Medicine 7: 80-81, 2017.
PREFACE
This excellent treatise covers extensive work by internationally recognized active and practicing clinicians who are members of the International College of Person-Centered Medicine. It is a crucial and indispensable subject for every health practitioner and persons involved in health care systems.
The first section focuses on Medical Professionalism, Ethical and Human Rights Foundations of Person-Centered Medicine, a person-Centered Approach by Physicians and the Concepts and Strategies of People-Centered Public Health.
The second section addresses the importance of Clinical Communication and empathy for Collaborative Care and discusses the concepts and procedures for Person-centered integrative diagnosis for a Person-Centered Assessment and Care across the lifecycle.
The last section highlights the importance of care planning and inter-disciplinary team decision making especially in mental and comorbid conditions, oncology cases, palliative Care, and other general conditions adequately in a person and people-centered way. This section also addresses the need for Inter-Professional Collaboration as a means for a broader person-centered perspective in medicine.
This book presents an authoritative overview of the person-centered educat