The idea of person-centred health systems is widely advocated in political and policy declarations to better address health system challenges. A person-centred approach is advocated on political, ethical and instrumental grounds and believed to benefit service users, health professionals and the health system more broadly. However, there is continuing debate about the strategies that are available and effective to promote and implement 'person-centred' approaches. This book brings together the world's leading experts in the field to present the evidence base and analyse current challenges and issues. It examines 'person-centredness' from the different roles people take in health systems, as individual service users, care managers, taxpayers or active citizens. The evidence presented will not only provide invaluable policy advice to practitioners and policymakers working on the design and implementation of person-centred health systems but will also be an excellent resource for academics and graduate students researching health systems in Europe. This title is available as Open Access on Cambridge Core.
Over the past decade health care systems around the world have placed increasing importance on the relationship between patient choice and clinical decision-making. In the years since the publication of the second edition of Shared Decision Making in Health Care, there have been significant new developments in the field, most notably in the US where 'Obamacare' puts shared decision making (SDM) at the centre of the 2009 Affordable Care Act. This new edition explores shared decision making by examining, from practical and theoretical perspectives, what should comprise an effective decision-making process. It also looks at the benefits and potential difficulties that arise when patients and clinicians share health care decisions. Written by leading experts from around the world and utilizing high quality evidence, the book provides an up-to-date reference with real-word context to the topics discussed, and in-depth coverage of the practicalities of implementing and teaching SDM. The breadth of information in Shared Decision Making in Health Care makes it the definitive source of expert knowledge for healthcare policy makers. As health care systems adapt to increasingly collaborative patient-clinician care frameworks, this will also prove a useful guide to SDM for clinicians of all disciplines.
This book's focus is on the decisions taken in consultations between health care patients and professionals. Clinician- patient partnerships in health care decisions are increasingly advocated. Evidence- based patient choice describes a model of health care in which the evidence-based approach can integrate with the promotion of consumer choice. The book examines the traditional approach and the changing experience and expectations of consumers. It describes with many clinical examples and patient narratives how to practice evidence-based patient choice, and explores the ethical, sociological and economic issues raised. It also addresses the future modifications to professional training and organisational change which are required if evidence-based patient choice is to become the norm and speculates about what is likely to be achieved in the next few years. The book provides a summary of current perspectives in this area, which will be of interest to consumers, their representative groups, and to professionals in practice and training alike. From the foreword by Richard Grol: 'An enormous challenge lies before us. In this new and challenging field Evidence-based patient choice is manna from heaven. It summarises the current state of knowledge about these new patient involvement approaches. It is by far the most comprehensive account of scientific and ethical thinking about patient choice at this moment. And, it manages to show us the way to a potential future: health care provision where patients and professionals operate as real partners with shared goals...'
Patients today are more empowered and knowledgeable than they have ever been. By law, they must be told about the risks and benefits of proposed treatments and give informed consent before treatment is initiated. Through the democratization of medical information, they have access to peer-reviewed medical journals. Social media allows patients to share stories with others and to learn about other people's experiences with various treatments. There are websites written by experts at leading medical schools to help patients understand diseases and treatments. They have the right to see their medical records. The net result of all changes is a shift in the power balance between doctors and patients. Ideally, as a result of these shifts, the patients' values and preferences should guide treatment decisions. However, this proliferation of information often leads to confusion rather than clarity. Publicly available information often includes seemingly contradictory conclusions and recommendations. Patients don't know which opinions to trust. So, although patients have more information than ever, and many want to make decisions for themselves, they need more guidance than ever to help them process an avalanche of information. This volume aims to help both medical professionals and their patients navigate the evolving healthcare landscape by analyzing the process of shared decision-making (SDM) in clinical medicine. The concept of SDM has emerged in the last two decades as a middle ground between, on the one hand, old-fashinioned physician paternalism of the "doctor-knows-best" variety and, on the other hand, unfettered patient autonomy by which patients are thought capable of individually and independently choosing their own medical interventions. Advocates of SDM imagine that decisions will be made best if they follow a complex discussion and negotiation between doctor and patient; such discussions should incorporate the doctor's medical and technical expertise as well as the patient's goals, values, and preferences. SDM takes different forms for different patients in different clinical circumstances. This volume gathers experts in SDM to share their insights about how it ought to be done. The authors include clinicians, social scientist, and philosophers, all of whom have thought about or cared for patients from a variety of backgrounds and in a variety of clinical circumstances. The papers explore the complexity of SDM and offer practical guidance, gained from years of experience, about how to employ SDM as effectively as possible.
The Mayo Clinic physician and founder of The Patient Revolution offers a “thoroughly convincing. . . call to action for medical industry reform” (Kirkus). Winner of the 2018 PenCraft Award for Literary Excellence, Why We Revolt exposes the corruption and negligence that are endemic in America’s healthcare system—and offers a blueprint for revolutionizing patient care across the country. Through a series of essays and first-hand accounts, Dr. Victor M. Montori demonstrates how the system has been increasingly exploited and industrialized, putting profit before patients. As costs soar, the United States continues to fall behind other countries on patient outcomes. Offering concrete, direct actions we can take to bring positive change to the healthcare system, Why We Revolt is an inspiring call-to-action for physicians, policymakers, and patients alike. Dr. Montori shows how we can work together to create a system that offers tailored healthcare in a kind and careful way. All proceeds from Why We Revolt go directly to Patient Revolution, a non-profit organization founded by Dr. Montori that empowers patients, caregivers, community advocates, and clinicians to rebuild our healthcare system.
This volume studies joint decision making in mental health care contexts through an in-depth examination of the negotiations of power and authority at the level of turn-by-turn sequential unfolding of interaction. Bringing together research at the intersection of mental health, discourse and conversation analysis it examines a wide range of settings including chronic psychiatric visits, rehabilitation meetings, occupational therapy encounters and cognitive behavioral therapy appointments. It presents a series of studies which reveal in close detail the joint decision-making processes in these critical encounters by using naturally occurring video-recorded interactions from a range of health service settings as data. In so doing, it sheds light on the interactional practices of health care workers that may facilitate or discourage client participation in joint decision-making processes. The book will provide important insights for academics and practitioners working in the fields of psychology, psychotherapy, applied linguistics, nursing, social work and rehabilitation; and in particular for those specializing in psychiatry and mental health.
"With a fine combination of humor, compassion and vast knowledge, Talya Miron-Shatz offers clear and useful guidance for the hardest decisions of life.” -Daniel Kahneman, Nobel award-winning author of Thinking, Fast and Slow A top expert on decision-making explains why it’s so hard to make good choices—and what you and your doctor can do to make better ones In recent years, we have gained unprecedented control over choices about our health. But these choices are hard and often full of psychological traps. As a result, we’re liable to misuse medication, fall for pseudoscientific cure-alls, and undergo needless procedures. In Your Life Depends on It, Talya Miron-Shatz explores the preventable ways we make bad choices about everything from nutrition to medication, from pregnancy to end-of-life care. She reveals how the medical system can set us up for success or failure and maps a model for better doctor-patient relationships. Full of new insights and actionable guidance, this book is the definitive guide to making good choices when you can’t afford to make a bad one.
