Patient centredness

Patient centredness is one of the current buzz phrases in the British National Health Service. At its best, the term expresses a great aspiration, a wish for health professionals to engage with patients as equal partners at a deep level that includes understanding both their illness and what it will mean for patients in their life context.¹ However, there are difficulties with the concept, both at the level of its definition and in its implementation.²,³

At its worst, it is simply a buzz phrase, which sounds good and allows managers and politicians to seem to be on the patient's side. In the wider economic sphere, Zuboff and Maxmin⁴ draw attention to the fact that many organisations that claim to be “customer focused” actually are not. Perhaps patient centredness is the health sector's equivalent term.

It is not always clear at what level patient centredness should apply. Is it at the level of individual doctors and patients? Is it at the level of the whole system? The idea that a healthcare system that has to provide care to millions of patients can be focused on one individual patient is clearly impossible.

It is far from clear that the health service should be entirely patient centred. The health service must exist to meet the needs of patients (if it does not do this, it has no function). The health service cannot conceivably meet the needs of patients solely by focusing on them.

Indeed, a one‐sided approach focused solely on patients risks alienating health professionals by playing down the importance of their professional knowledge and skill. The knowledge of medicine, and related professions, is entirely patient centred in that it is all ultimately derived from the study of patients. It has only one purpose, which is to help patients, and it is only brought to fruition when this goal is achieved.

The argument should not be about patient or professional centredness. The key unit of medicine is the professional–patient dyad, the interaction in which hopefully the professional and the patient come to a useful shared understanding of the patient's illness or predicament.⁵

A truly patient‐centred National Helth Service would support both sides of the professional–patient dyad appropriately, and would not look to champion one against the other. It would be a shame if the ideal of patient centredness was lost to one‐sided interpretations of the term.