Client-centeredness

I read this ages ago and didn’t have time to blog about the topic until now. Client-centeredness is important to health care practice. The “I’m going to tell you what to do and you’re going to do it” days are over. However, we are still the professionals. We keep up with the most current research, we have the training and skills necessary to observe and evaluate the human condition, people consult us for our expertise for a reason — in some ways, on some levels, we do know better. This knowing is a general knowing. The client/patient knows better about their own experience, yes, but we know better about the generalities. We can provide context to their experience, general information, prognosis, expected side effects, consequences of not following through with treatment, evidence, etc.

IMHO, client-centeredness is more than “considering the client’s point of view” and it’s more than “the client is the expert of themselves”. It’s also being responsible enough not to peddle bullshit just because the patient is bullying us into it by calling us “closed minded” for not fully supporting their trip to Woo Land. It is up to us not only to explain why woo is bad, but also why science-based medicine is beneficial — within the context of the costs and benefits of each. We have to explain our rationale behind the decisions we make to allow for more transparency so that clients/patients can see that we are working in their best interests, as our job entails, and not for some made-up entity like Big Pharma. And we have to do it in a way that doesn’t make them out to be morons. Because they are not health care professionals, so how can we expect them to have the skills to make those decisions?

In my case, as I’m just starting out and need to find an approach, rather than treat the situation as “woo versus medicine” I wonder how beneficial it would be to consider all the woo options (that the patient has brought up) and science-based options together and provide the benefits and caveats of each all together. This way the patient sees that I am taking their thoughts into account, but I’m also providing them with all of the information in context. However, there is the argument that talking about everything on equal ground lends false legitimacy to the claims. But that’s not really what I’m concerned about when I interact with patients. I’m concerned about their well-being and them wasting time in their course of treatment because of something they read on some website that was peddling easy answers with no personal effort but lots of money.

Any health care professionals out there reading this? Care to share your approach? Do you find that your approach is well-received?

People say we are a more “informed” health consumer group because of the internet. I call bullshit on that, in some ways. Rather than being more informed, they’re just inundated with more information — most of it terrible. And unskilled people are left sorting through it all, coming to conclusions that are convenient for them, and then arguing with real health professionals as if Google supersedes years of training. Somewhere, somehow, the public opinion of health care became that we are selfish paternalists bastards looking to put people through our offices as quickly as possible and unwilling to listen to their point of view. In reality we’ve devoted years of study, and the subsequent rest of our frigging lives to helping other people. And although there is a limited time in our appointments, it’s our responsibility to make it clear that we are fallible but we have the skills to sift through this information. It’s our responsibility to help the patient understand all of the information. If we don’t have time to do that, it’s our responsibility to advocate for that time.

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