Moira Stewart et al. - Patient-Centered Medicine: Transforming the Clinical Method

The principles underpinning the patient-centered clinical method remain constant but the components have changed: there are now four components instead of six. Being Realistic, one of the previous components, was considered not to be part of clinical care and so its material on time and teamwork was moved to other parts of the book. Prevention and Health Promotion, the second of the previous components to be changed, was considered to be incorporated into each patient-clinician interaction and therefore has become part of the other components. Conceptual clarity has been achieved regarding where Health Promotion fits in patient-centered care and where Prevention fits ( see ). The teaching and learning chapters comprise an up-to-the-minute compendium of the relevant education literature and methods. The research chapters illuminate patient-centered concepts through stories of lived experiences, and they also provide clear, positive, and uplifting messages about the important impact of patient-centered clinical care.

This book is divided into five parts. Part One contains an introduction to the patient-centered clinical method, including its evolution and relationship to other models of care. In addition, common misconceptions about the meaning of patient-centeredness are elucidated. The second chapter in this part is a historic perspective written by Ian R McWhinney.

Part Two describes the four interactive components of the patient-centered clinical method. Chapters 37 elaborate in detail Components 14, respectively. The clinical reader will notice the cases illustrating each of the four components of the patient-centered approach that are embedded in Chapters 37. Those most interested in the application of patient-centeredness in everyday practice might enjoy reading the cases first. As McWhinney (2001: 88) has wisely noted, An actual case brings things alive for us in a way that aggregated data cannot do. Taken together, the cases represent a typical series of patients in the practice of a busy doctor. All the cases are based on actual clinical encounters; however, the names, dates, and places have been altered to ensure the confidentiality of the participants.

Part Three, on teaching and learning, contains five chapters..

Part Four of the book deals with two key health care contexts within which patient-centered clinical care is enacted. In the preoccupation with cost restraint in health care is dealt with by providing the news that patient-centered care saves money.

Part Five, on research, combines reviews of relevant literature with descriptions of important measures. Qualitative and quantitative methodologies are represented. describes a measure we have developed that uniquely assesses encounters according to the patient-centered clinical method.

In the final chapter, we summarize the key messages of this book and look to the future of challenge and reward in the practice, teaching, and research of the patient-centered clinical method.

Moira Stewart

Judith Belle Brown

W Wayne Weston

Ian R McWhinney

Carol L McWilliam

Thomas R Freeman

London, Ontario, Canada

October 2013