Throughout its two thousand year history, Western medicine has been dominated by two broad strategies which drive the delivery of health care.
– In system-centered care, the needs and benefits of the system- the health care facility and the health care professionals staffing it- drive the provision of care.
– In patient-centered care, the strengths and needs of a patient drive the provision of care.
But there is a third strategy which, until recently, has been vastly underutilized- yet which could be even more effective and efficient than either strategy listed above.
– In family-centered care, the priorities and choices of a patient and their family drive the provision of care.
An example of the differences in the presentation of care is demonstrated by the Association for the Care of Children’s Health. Consider a hypothetical scenario of a patient requiring a special diet while in the course of receiving health care interventions.
– In a system-centered care facility, test results may be required to be sent ahead before a nutritionist consult is granted; the patient’s health insurance (or lack thereof) may be taken into account; overall, considerations will be made based on their benefit to the health care facility, rather than the patient (i.e., making dietary decisions before the patient has had contact with a nutritionist).
– In a patient-centered care facility, a nutritionist may assess the patient, design a meal plan, and give it to the patient. While this approach does address the clinical needs of the patient as it is addressed within the confines of the health care facility, it does not address detriments this approach may produce. Often not considered are the patient’s ability to provide for themselves; how their nutritional needs may change upon discharge from the hospital; how nutrition relates to the patient’s health care diagnosis; as well as their dietary preferences and cultural practices are often not considered.
– In a family-centered care facility, a nutritionist may ask to meet with the patient and their family to jointly design a meal plan in line with the patient and family’s resources, preferences, and other realities of their ability to provide continuing care outside the health care facility. Great emphasis is placed on the family’s ability to help the patient provide a continuance of a care diagnosis after they are discharged from a health care facility.
Recent studies suggest that family-centered care is the most effective method of delivering health care services. This is especially important in light of our search for an answer to the health-care crisis currently facing our nation.
But why is family-centered care more effective- and how does it impact our goal of providing essential health care services to every American citizen?
