By: Wafa Asadian (2015)

Wafa Asadian is a PhD candidate at UBC Faculty of Education. Her dissertation research is about patient and community involvement in health professional education.

_______________

Patients’ Voice: The Expectation of the New Era

A contemporary issue in the health care system is how to manage and deal with chronic illness given the increasing costs of health care and the efforts to keep patients out of hospitals whenever possible. A recent trend is to offer services in a way that patients can take ownership of their own health condition, and physicians and health professionals can help patients through this process of personal care management. In this process, which is called patient-centred care (PCC), patients’ needs and life context are prioritized in the process of consulting, diagnosis, and treatment (e.g., Mead & Bower, 2002). In this approach, patient and physician engage in a dialogue that involves the patient’s perspective, knowledge, experience, life context, and other health-related conditions. However, it is unclear to what extent Canada’s health care providers fulfill their mission of patient-centred care. More specifically there is no evidence that health professionals and physicians in particular routinely apply the PCC approach in their practice after they receive their license. It appears that the needs and voice of the patients are missing in the health care system.

Despite a government commitment to excellence in health care, Canadian health care and delivery have some deficiencies. In comparison with other countries with high economic development, Canada ranks low in after-hours care, highest in wait times for secondary referral and low in access to specialists (Sutherland, 2013), lowest in chronic care delivery such as in diabetes, and lowest in team-based and inter-professional chronic care (Morgan et al., 2007). Such deficiencies in the health care system can result in perilous and fatal consequences for patients—that call not only for a review of the structure of the health care system and its internal dynamics, but of the way that health professionals are educated and trained. It is arguable that the aging population and the growing need for chronic care are the least reasons that warrant reforming health professional education from acute care to chronic care.

The Canadian medical schools need to offer new methods to their students in an effort to foster patient-centred care. In other words, health professional education, which usually relies on medical scripts and lectures, must recognize the patients’ experience by having real persons with a medical condition directly share their story with the illness and the health care system. There are a number of Canadian medical schools that have recognized the value of patients’ voice, including the Health Mentors Program (course) at the University of British Columbia in which a patient with a chronic condition teaches an inter-disciplinary group of health professional students about her/his condition of living with an illness. In this course, patients have their voice heard by the future health professionals, and the students learn to look at illness in a holistic perspective, that is looking at the life circumstances and the whole person rather than their symptoms and disease. Although these courses are often not mandatory and their long-term impact needs to be investigated, they are valuable in starting a dialogue on the inclusion of patients who are the main stakeholders in the patient-centred care.

References

Mead, N., & Bower, P. (2002). Patient-centred consultations and outcomes in primary care: A review of the literature. Patient Education and Counseling, 48(1), 51-61.

Morgan, M. W., Zamora, N., & Hindmarsh, M. F. (2007). An inconvenient truth: A sustainable healthcare system requires chronic disease prevention and management transformation. Healthcare Papers, 7(4), 6-23.

________________________________________________________________________