How Patient-Centered Medical Homes Can Bring Meaning to Health Care: A Call for Person-Centered Care

James W. Mold; F. Daniel Duffy

doi:10.1370/afm.2827

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RE:How Patient-Centered Medical Homes Can Bring Meaning to Health Care: A Call for Person-Centered Care
R. Scott Hammond

Published on: 14 August 2022
RE: Great Concept, Now the Methodology
William D Grant

Published on: 28 July 2022
RE: How Patient-Centered Medical Homes Can Bring Meaning to Health Care: A Call for Person-Centered Care
Bruno Kissling

Published on: 26 July 2022

Published on: (14 August 2022)
Page navigation anchor for RE:How Patient-Centered Medical Homes Can Bring Meaning to Health Care: A Call for Person-Centered Care
RE:How Patient-Centered Medical Homes Can Bring Meaning to Health Care: A Call for Person-Centered Care
R. Scott Hammond, Family Physician, President, Colorado Center for Primary Care Innovation and Clinical Professor, Univ Colorado School of Medicine, DOFM
Jim Mold's article on GOC and PCMH helps in understanding the evolutionary differences from PCMH. What GOC defines and operationalizes is the essence and foundation of medicine - a healing relationship. This is in contrast to a curing relationship that aims to fix a problem or achieve a health plan driven measure that may or may not be beneficial or meaningful to the person. This is what we all understand in primary care - the difference between what can be done and what should be done. GOC provides the tool to change our treatment strategies and engage our patients as their circumstance change, as it seems, from visit to visit.

I think we all went into medicine for both the love of science and the strong desire to help people. For many, the science is the focus. For me, the concept of helping has changed over time. Initially, I focused on relief of suffering as my charged outcome. Over time, I determined that facilitating healing was a truer path. Clinical knowledge and skills can make you a great physician but it takes wisdom, patient knowledge and compassion to become a healer.

Even the word physician has evolved from the Greek, phusike (knowledge of nature), to Latin, physica (natural science), to Old French, fisique (art of healing), to Middle English, fiscien (physician) in the 1200s primarily to distinguish a practitioner of physic from surgeons.

Over time, have we lost our connection with our patients? As our roles continue to evolve in...
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Jim Mold's article on GOC and PCMH helps in understanding the evolutionary differences from PCMH. What GOC defines and operationalizes is the essence and foundation of medicine - a healing relationship. This is in contrast to a curing relationship that aims to fix a problem or achieve a health plan driven measure that may or may not be beneficial or meaningful to the person. This is what we all understand in primary care - the difference between what can be done and what should be done. GOC provides the tool to change our treatment strategies and engage our patients as their circumstance change, as it seems, from visit to visit.

I think we all went into medicine for both the love of science and the strong desire to help people. For many, the science is the focus. For me, the concept of helping has changed over time. Initially, I focused on relief of suffering as my charged outcome. Over time, I determined that facilitating healing was a truer path. Clinical knowledge and skills can make you a great physician but it takes wisdom, patient knowledge and compassion to become a healer.

Even the word physician has evolved from the Greek, phusike (knowledge of nature), to Latin, physica (natural science), to Old French, fisique (art of healing), to Middle English, fiscien (physician) in the 1200s primarily to distinguish a practitioner of physic from surgeons.

Over time, have we lost our connection with our patients? As our roles continue to evolve in this chaotic and disorienting health care world, our roots should remain to create an 'optimal healing environment’ (Samueli Institute 2004) for our patients, Healing can only occur by understanding the patient as a whole person. As we heal our patients, we too, as clinicians, will heal. GOC can reconnect us to our patients and profession. Our small PBRN will begin implementation of GOC this fall and start our journey.
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Competing Interests: None declared.
Published on: (28 July 2022)
Page navigation anchor for RE: Great Concept, Now the Methodology
RE: Great Concept, Now the Methodology
William D Grant, Professor Emeritus Family Medicine and Emergency Medicine, SUNY Upstate Medical Univeristy
This is a great overview and meaningful discussion of patient-centered care. My personal experience in three different family practices have proven frustrating in the implementation process. The meaning and individual responsibilities of the components of the coordination of care is poorly understood by physicians and by patients. Most importantly by patients. After being introduced to the concept by physicians who say that they have a patient centered practice and their role is to coordinate care, the reality is that the patient becomes responsible for coordinating care of specialists even ones to whom the patient has been directed. This means gathering reports, having lab and image reports transmitted, and interpreting the reports to the PCP. The physicians rarely communicate with each other in almost any way, even those on the same electronic medical record system. I would like to see the next paper as an implementation methodology with clear roles responsibilities and expectations of all who are in the coordinated care system.

Competing Interests: None declared.
Published on: (26 July 2022)
Page navigation anchor for RE: How Patient-Centered Medical Homes Can Bring Meaning to Health Care: A Call for Person-Centered Care
RE: How Patient-Centered Medical Homes Can Bring Meaning to Health Care: A Call for Person-Centered Care
Bruno Kissling, Retired Family Doctor, former physician in a private family doctor praxis in Berne Switzerland
Dear colleagues James W. Mold and F. Daniel Duffy,
thank you very much for your great article. Like you I'm also convinced, that the change from a disease-oriented to a person-centred medicine is one of the next steps our modern medicine has to do.
My co-author Peter Ryser, a systemic, solution-oriented supervisor, counselor and teacher and me, a retired family doctor, published last year the book "Mastering the medical consultation - s systemic, solution-oriented process" 2021. The book was first published in German in 2019 and awarded with the Book Prize of the European Society for Person Centered Healthcare by Andrew Miles in 2020. We walk in "slow motion" through a consultation and show pracitcally (with sample questions) and discuss thoretically how a consultation can be performed in a person-centred way.
Let's hope that your and our efforts can contribute to promote the person-centred approach to the patients.
Best wishes
Bruno Kissling, Bern, Switzerland

Competing Interests: None declared.