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Teaching Patient- and Family-Centered Care

Teaching Patient- and Family-Centered Care

21st Century Medicine That Is Respectful and Compassionate

One of our strategic priorities is to become the national leader in providing and teaching patient- and family-centered care. That tradition began 123 years ago, when the founders of our medical school insisted that physicians learn to listen carefully to—and consider—patients’ accounts of their own illnesses. Although technology should make it easier than ever to partner with our patients, some clinicians worry that humanistic medicine is becoming harder and harder to practice.

Many in the medical profession are wrestling with how to ensure that we balance cutting-edge medicine and lifesaving technologies with the need for a human touch and listening to what a patient wants and values.

On one hand, the central precept of the profession is compassion. Many of us enter the field of medicine to help our patients and their families relieve suffering. However, there are factors that impinge on humanism in the practice of medicine, including:

  • The time required to study and master vast quantities of highly technical information
  • The time constraints of a busy practice
  • The distancing effect of increasingly sophisticated technologies
  • Increasing bureaucracy and documentation
  • Burnout or disillusionment

The good news is that medical training has been trending in a more humanistic direction over the past decade in our attempts to produce a more compassionate workforce. Change in medical schools’ selection criteria produces more caring physicians. For example, at Johns Hopkins, we look not only at MCAT scores but also at the candidates’ interests and activities, their commitment to the world around them, and the qualities highlighted in their letters of support.

In addition, there have been positive changes to both the medical school curriculum and the residency model. Under our revamped Genes to Society curriculum, students begin speaking with patients in the clinic in the first month of medical school and focus on the impact that social, community and environmental issues have on the health of individuals. We’ve also made great strides in our residency training. Work hours have been reined in for interns and residents, and we require our trainees to participate in service projects to help them develop empathy and the ability to relate to people of different backgrounds.

The new, state-of-the-art Capacity Command Center at The Johns Hopkins Hospital improves our ability to manage the flow of our patients, making sure that each individual receives the specific care needed while also allowing more patients access to our services.

At the same time, we are moving toward exclusively single-patient rooms in all of our hospitals, in part so that patients’ conversations with their doctors are more private.

Health care providers have also adopted policies to preserve the intimacy of the physician/patient relationship, including setting up exam rooms to keep the note-taking laptop out of the way so the doctor can still face and make eye contact with the patient.

As physicians, it behooves us to get patients involved in the healing process—to try to understand their goals and find the path that best meets their needs. Caring doctors are better doctors. They practice safer medicine, earn more trust from patients and get them more engaged in their own health care, leading to better outcomes. To lead this change, we must be creative in managing the demands associated with the practice of medicine while fulfilling our firm commitment to knowing our patients and understanding their needs.

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