“Nothing about me without me”

This is my take home message from the third day at the Telluride experience. This is the essence of patient centered approach. When health care providers assume the paternalistic approach, it comes to the level that the provider designs the care/ management in the way the provider wants it to be. The expectation from the patient is to accept it. So the decision maker is the provider. Patient is forced to agree with anything and everything asked by the care provider without even knowing what is it for or how it is going to affect the patient or what are the alternatives or choices available. In other words, irrespective of patient’s choice, the patient becomes forced to say yes. In this process, patients do not receive the required information. Medical language, rushing providers, lack of consistency and continuity of care , patient’s feeling of uncertainty about the outcome and their helplessness makes the communication efforts even worse. As a result, patients often agree for procedures which they may not agree if they had received the required information to make an informed choice. Patient, who is the center of the care gets pushed out of the picture. It is time for a change where patients take control of their care by becoming an equal partner.

Lack of information hurts the provider community as well. If the outcome is unfavorable, the providers who dealt with the patient with their paternalistic approach and made decisions on patient’s behalf will experience the toughest task. If the patient care was formulated with patient as a partner in care, the provider can approach the patient and the loved ones since the trust which was already developed will make that communication more sincere and acceptable.

Our patients have a right to be informed about their care. Next time, when we have to rush from a patient,  or we may have to make choices on patient’s behalf, remember, the patient is reminding us, ” nothing about me without me”.

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