4th Edition
Patient-Centered Medicine Transforming the Clinical Method
The Patient-Centered Clinical Method (PCCM) has been a core tenet of the practice and teaching of medicine since the first edition of Patient-Centered Medicine - Transforming the Clinical Method was published in 1995. This timely fourth edition continues to define the principles underpinning the patient-centered clinical method using four major components, clarifying its evolution and consequent development, and it brings the reader fully up to date. It reinforces the relevance of the method in the current much-changed realities of health care in a world where virtual care will remain common, dependence on technology is rising, and societal changes away from compassion, equity, and relationships toward confrontation, inequity, and self-absorption.
Fully revised by its highly experienced author team ensuring wide interest and written for those practising now and for the practitioners of the future, this new edition will be welcomed by a wide international audience comprising all health professionals from medicine, nursing, social work, occupational therapy, physical therapy, pharmacy, veterinary medicine, and other fields.
Dedication
Preface
About the authors
List of contributors
Acknowledgements
PART ONE: OVERVIEW
1. Introduction
Moira Stewart, Judith Belle Brown, W Wayne Weston, Thomas R Freeman, Bridget L Ryan, and Carol L McWilliam
"The Man, the Poem, the Secret": Case Illustrating All Components
Peter Lucassen
"Love in the Time of HIV": Case Illustrating All Components
Sudit Ranade
2. The Evolution of Clinical Method
Ian R McWhinney
PART TWO: THE FOUR COMPONENTS OF THE PATIENT-CENTERED CLINICAL METHOD
Introduction
Judith Belle Brown and Moira Stewart
3. The First Component: Exploring Health, Disease and the Illness Experience
Moira Stewart, Judith Belle Brown, Carol L McWilliam, Thomas R Freeman and W Wayne Weston
"Empowering A Teen’s Decision": Case Illustrating Component 1
Melad Marbeen
"Indecision Around Contraceptive Use": Case Illustrating Component 1
IkeOluwapo O Ajay and Omolara Lewechi-Uke
4. The Second Component: Understanding the Whole Person,
Section 1 ‒ Individual and Family
Judith Belle Brown and W Wayne Weston
"Now I Know What it's Like": Patient Voice Illustrating Component 2 – Individual and Family
Britta Laslo
"Finding a Voice": Case Illustrating Component 2 – Individual and Family
Nisanthini Ravichandiran
5. The Second Component: Understanding the Whole Person
Section 2 ‒ Context
Thomas R Freeman, Judith Belle Brown and Carol L McWilliam
"The Power of Context and Continuity": Case Illustrating Component 2 – Context
Peter Lucassen and Juul Houwen
6. The Third Component: Finding Common Ground
Judith Belle Brown, W Wayne Weston, Carol L McWilliam, Thomas R Freeman and Moira Stewart
"Agreeing to Disagree": Case Illustrating Component 3
Eng Sing Lee
"The Cycle of Life": Case Illustrating Component 3
Caroline Villa Martignoni Rebicki
7. The Fourth Component: Enhancing The Patient-Clinician Relationship
Moira Stewart, Judith Belle Brown and Thomas R Freeman
"About Christine": Case Illustrating Component 4
Jennifer K Johnson
"You Couldn't Have Prevented This": Case Illustrating Component 4
Olivia Reis
"A Man and a Woman": Case Illustrating Component 4
Peter Lucassen
PART THREE: APPLICATIONS OF PATIENT-CENTERED PRINCIPLES IN A VARIETY OF HEALTH CARE CONTEXTS
Introduction
Moira Stewart
8. Team-Centered Approach: How to Build and Sustain a Team
Moira Stewart, Judith Belle Brown, Bridget L Ryan, Thomas R Freeman, Carol L McWilliam, Joan Mitchell, Lynn Brown, Lynn Shaw and Vera Henderson
"The Team was the Container for Her Story": Case Illustrating a Team-Centered Approach
Lynn Brown
9. Patient-Centered Approaches in the Face of New Technologies
Moira Stewart, Bridget L Ryan and Thomas R Freeman
PART FOUR: LEARNING AND TEACHING THE PATIENT-CENTERED CLINICAL METHOD
Introduction
Judith Belle Brown and W Wayne Weston
10. Becoming a Physician: The Human Experience of Medical Education
W Wayne Weston and Judith Belle Brown
"A Messenger": Case Illustrating Becoming a Physician
Barry Lavallee and Judith Belle Brown
11. Learner-Centered Teaching
W Wayne Weston and Judith Belle Brown
"Being There": Case Illustrating Being Learner-Centered
Christine Rivet and Judith Belle Brown
12. Challenges in Learning and Teaching the Patient-Centered Clinical Method
W Wayne Weston and Judith Belle Brown
13. The Case Presentation as a Teaching Tool for Patient-Centered Care
Thomas R Freeman
"Janna: I've lost my support. He was my support, he did everything"
Thomas R Freeman
PART FIVE: RESEARCH ON PATIENT-CENTERED CARE
Introduction
Moira Stewart
14. Using Qualitative Methodologies and Mixed Methods Approaches to Illuminate Patient-Centered Care
Judith Belle Brown and Bridget L Ryan
15. Evidence of the Impact of Patient-Centered Care on Clinician Well-being and Patient Outcomes
Moira Stewart and Bridget L Ryan
16. Measuring Patient Perceptions of Patient-Centeredness
Moira Stewart, Judith Belle Brown, Bridget L Ryan and Leslie Meredith
17. Measuring Patient-Centeredness
Judith Belle Brown, Moira Stewart and Bridget L Ryan
PART SIX:
18. Conclusions
Moira Stewart
Index
Biography
Moira Stewart, PhD, is a Distinguished University Professor Emeritus at the Centre for Studies in Family Medicine at Western University Canada and the Dr Brian W Gilbert Tier 1 Canada Research Chair in Primary Health Care Research (2003-2017). Dr Stewart has published widely on the topic of Patient-centered Care.
Judith Belle Brown, PhD, is a Professor in the Centre for Studies in Family Medicine, the Department of Family Medicine, Schulich School of Medicine & Dentistry at Western University, London, Ontario, Canada. She is the Chair of the Masters in Clinical Science (MClSc) and PhD programs in Family Medicine at Western, both of which are offered via distance education. She is the Co-Chair of TUTOR-PHC an interdisciplinary research training program.
W Wayne Weston, MD, CCFP, FCFP, is Professor Emeritus of Family Medicine at the Schulich School of Medicine & Dentistry, Western University, Canada. He had a key role in creating the Center for Education Research and Innovation at Western.
Bridget L Ryan, PhD, is an Epidemiologist and Associate Professor at the Centre for Studies in Family Medicine, and the Departments of Family Medicine and Epidemiology and Biostatistics at Western University, London, Ontario, Canada. She is Co-Principal Investigator on a CIHR grant developing primary-care-based digital tools to support family physicians and patients to talk about social isolation and health.
Carol L McWilliam, MScN, EdD, is a retired Professor in the Arthur Labatt Family School of Nursing, Faculty of Health Sciences, at Western University, London, Canada. She conducts research in the areas of health promotion, health services delivery, and relationship building, with a focus on patient-professional and inter-professional communication.
Ian R McWhinney, OC, MD, FCFP, FRCP, (1926-2012) was Professor Emeritus in the Department of Family Medicine at Western University, Canada. He was born in Burnley, Lancashire and educated at Cambridge University and St. Bartholomew's Hospital Medical School.
