Patient-centric care: Has the pendulum swung too far?

 

         Frankly, many healthcare providers think so ( including this author ). Until recently, it was not much an issue for many clinicians. In fact, many healthcare providers embraced this about-face from the medical profession’s long-held stance of centuries old practice of paternalism. In the old model the mantra was: healthcare providers knew best,. However, nowadays, supporters of the new paradigm of patient centric-care have altered the playing field to such an extent that one would have never imagined anticipating that it would become one in which dictates the patient always knows best or is always correct.

         Who knew or would have anticipated the proponents and supporters of the “patient autonomy movement” would have garnered so much power in their own advocacy role to technically open the door to patients’ capriciousness creating such havoc. But, truthfully, can a provider assure the patient that their wellbeing and safety will not be jeopardized when the overseeing professional’s clinical judgment or guidance is removed or relegated from the clinical-decision making process all because the imperative mantra of patient satisfaction comes first?

         Isn’t this new imposed “business metric”  by HCOs “patient advocates” or office managers on practicing clinicians absurd?  Of course it is, if your tenure is “indirectly” threatened or being “blacklisted as an insubordinate” all because you were non-compliant with this loaded hypocritical economic metric. For example, I know of several colleagues who lost their jobs for not providing unneeded prescriptions for abusive demanding difficult patients. Since when patients' self-prescribed under our licenses?

         Personally, it infuriates me, when non-clinicians try to justify or relegate a medical encounter to a business transaction always under the pretext of patient satisfaction is paramount to the “satisfaction scores”. Even when superseding acknowledged contraindications even when not clinically indicated. For instance, a known prior documented PMHx of substance abuse/dependency and mental health issues in a given patient. Simply put: quite troubling if not beyond comprehension in these instances.

         Or prescribing antibiotics on non-meritorious clinical presentations, for example patients with clear viral syndromes is a very disingenuous if not a corrupted business practice. Patient satisfaction should not mean “carte blanche” treatments under no circumstances.

         So, are we ( the healthcare industry ) losing sight of what’s truly  really important? Yes, if we continue submissively accepting and practicing medicine under these lines of blurred expectations & downright unethical conflict of interests if you ask me. Burdensome and extremely short-sighted and/or professionally threatening as these mandates might appear, we, the medical community must individually & collectively remain vocal and resolute when denouncing these unrealistic and misguided expectations from other parties.

         To sum it up: respect for patient-centric care, not administrative threats is key to sound patient-provider relationships. Do not allow yourself ever to be pigeon-holed into thinking that a medical encounter boils down to a mere economic transaction or a survey metric. By doing so you’re basically allowing the demise and disrespect of our professional calling and standing in the industry. Moreover, you allow a pervasive view of financial gains trumping patient beneficence, thus allowing the subjective dimension of patients’ satisfaction scores rein unchecked and rein unbalanced, akin to allowing the pendulum to swing way too far...if you asked me.