Patient-centered care

Patient-centered care (Peter and Maria Hoey, For The Times / September 13, 2012)

At Stanford University, a new hospital — scheduled to open in 2016 — is being built as a patient-centered facility.

Every one of the 368 rooms will be private, and Internet access will keep patients in constant contact with the outside world. Families will be allowed to visit 24/7, even in intensive-care units. Plus they'll be able to talk with doctors either in person or on a closed-circuit video monitoring system, which can record the discussions and replay them later.

One entire floor — including a huge garden with meandering paths and ocean views — will be reserved for patients and their families. In fact, as much as possible, "the patient experience and the public experience will be separate," says Amir Dan Rubin, chief executive of Stanford Hospital and Clinics.

With your doctor's help, you'll be healthier.

Research shows that patient-centered care leads to better outcomes.

For example, diabetes patients manage their condition better when their doctors show empathy and take time to talk with them about their situation, according to Rickert. "Maybe it's because they have a greater desire to please, or because they understand their treatment better, or they get the extra support they need to stay on track," he says.

There is also evidence that patient-centered care can reduce costs. In a year-long study of 509 adults published in 2011, a patient-centered approach was correlated with fewer visits for specialty care, fewer hospitalizations, fewer lab and diagnostic tests and lower total medical costs.

Doctors want to improve outcomes and lower costs as much as anybody. But they also want to get paid. And under the current fee-for-service payment model, doctors have little financial incentive to practice patient-centered care. Even Rickert, a strong advocate of patient-centered care, says he loses money by practicing it.

"There's a lot of reform coming down the pike," says Dr. Steven Atlas, director of the Primary Care Research and Quality Improvement Network at Massachusetts General Hospital. "As we change doctors' relationship with patients, how we pay doctors will have to change too."