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Patient-Focused Care^*

Using the Right Tools

^* From the Pulmonary, Allergy and Critical Care Medicine Division (Dr. Irwin), University of Massachusetts Medical School, Worcester, MA; and Magenta Communications (Ms. Richardson), Ltd. Oxon, UK.

Correspondence to: Richard S. Irwin, MD, FCCP, Pulmonary, Allergy and Critical Care Medicine Division, University of Massachusetts Medical School, 55 Lake Ave North, Worcester, MA 01655; e-mail: Irwinr{at}ummhc.org

Patient-focused or patient-centered care is not a new concept, but its value has been overlooked in preference to the technology-based, disease-centered model that has prevailed in medicine for the last 50 years. Patient-focused care includes four broad areas of intervention: communication with patients, partnerships, health promotion, and physical care (medications and treatments). We can conceptualize patient-focused care as being the care we would like our loved ones to receive. There is considerable evidence that patients prefer a patient-focused approach. Unfortunately, there are also many studies detailing physicians’ disconnection with patients’ needs, particularly the need for information, and misunderstandings and assumptions based on poor communication. However, it is possible to develop physicians’ skills in patient-focused care and provide physicians with the tools to overcome the barriers to this approach. The patient-focused approach has been shown to improve physicians’ performance, patient satisfaction, and health outcomes without requiring additional investment in time or resources. Patient-focused care has also been shown to improve adherence to medication/advice, a well-known problem in asthma. There are also benefits to the physician in terms of improved outcomes for their patients, higher patient retention, and potentially a reduced risk of litigation. Patient-focused care may be a particularly valuable approach for the management of "difficult-to-treat" patients. In summary, the "three Cs" of patient-focused care—communication, continuity of care, and concordance (finding common ground)—are highly relevant to the effective treatment of pulmonary disease and should be a key component of asthma management.

Key Words: asthma • asthma management • patient-centered care • patient-focused care • physician-patient relationship

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