Saturday, July 15, 2017

A shift towards person-centric medicine

Every person has a distinct unique set of characteristics that distinguishes them from the other.

“Individualization” is inherent in the science of homeopathy, which recognizes every patient to be different from the other, even if they have the same disease and individualizes treatment for every person.

The modern system of medicine is also now shifting towards person-centric medicine. Every patient has to be managed differently for the best possible outcome. What is acceptable to one patient, may not be acceptable to the other. Treatment must be tailored to each individual patient taking into consideration their individual characteristics, culture, personal preferences, expectations etc.

The Institute of Medicine (IOM) has defined patient-centered care as: “Providing care that is respectful of, and responsive to, individual patient preferences, needs and values, and ensuring that patient values guide all clinical decisions.”

A few days back, I spoke about the social determinants of health; the social situation of the patient, environmental factors, which influence health of a person. These may differ from patient to patient. Their personal and family history including medical history are different. Individual response to drugs may vary, the side effects may vary. All these variables need to be taken into account when formulating a treatment plan.

For this reason, the standard treatment guidelines need to be challenged. Guidelines are evidence-based recommendations for groups of patients, but not the individual patient. While they give a direction, they cannot be applied to all patients alike. Doctors must exercise clinical judgement in selecting the best treatment option for a particular patient. 

Individualized treatment plans are based on the unique demands of that particular patient and address the needs of that patient and what the patient wants. They also involve the patient and encourage shared decision making with the patient and the family.

Dr KK Aggarwal

National President IMA & HCFI

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