On the need for transformational leadership in the delivery of person-centered clinical practice within 21st Century healthcare systems

Abstract

We write this Editorial Introduction following the conclusion of the First Annual Conference and Awards Ceremony of the European Society for Person Centered Healthcare (ESPCH) hosted by Francisco de Vitoria University, Madrid, Spain, on 3 & 4 July 2014. The Conference proved an important event which successfully brought together a very wide range of distinguished speakers and delegates from across the length and breadth of Europe, the United States of America, Canada, Australia, New Zealand and elsewhere. Following the close of Day One of the Conference, and prior to the Conference Dinner, we were pleased to confer on particularly eminent colleagues, the Society's Platinum, Gold, Silver and Bronze Medals, the Presidential Medal and the Senior Vice Presidential Medal and, in addition, to award the Society's Essay Prize and Book Prize. A full Conference Report, with the usual obligatory photographs and a YouTube videolink to highlights of the proceedings, has been included within the first e-Bulletin of the European Society for Person Centered Healthcare, the Society's new bi-monthly and detailed Newsletter.

Multimorbidity—A manifestation of network disturbances? How to investigate? How to treat?

“…Additionally, and apart from its major conferences and symposia, the ESPCH has embarked on the organisation and delivery of specific training programmes and masterclasses, which are specifically designed to upskill clinicians in the use of condition‐specific guidance and who, following such training, are then able to return to their institutions as teachers, mentors, and leaders. Through such work, which is usefully informed by important studies of multimorbidity such as those being undertaken by Sturmberg et al, the ESPCH has already been able to achieve demonstrable changes within the medical and health care culture, in the thinking of politicians and policymakers and in advising the health care industry in how best to make its own contribution to patient‐centricity . As the ESPCH continues to grow rapidly, so does its expertise and the Society welcome enquiries from all colleagues with an interest in or responsibility for the development of person‐centered health care.…”

Carers – vital partners in increasing the person-centeredness of health and social care systems

“…While the role of a carer is well understood in general terms, more detailed descriptors that better illustrate the different types of carer and caring are needed and in a forthcoming Preliminary Lexicon and Dictionary of Terms for PCH [15,16] we suggest some possible examples. Despite the current lack of definitional precision, it is clear that people who act in this role perform a service of great importance and one which is directly related to the success of strategies to implement person-centered approaches within health and social care systems.…”

Towards a person-centered medical education: challenges and imperatives (I)

“…Indeed, this movement has aimed, principally, at achieving a re-balancing of medicine's science with medicine's humanism, seeking to remind clinicians that patients' subjective needs (as expressed by them through narratives, values, preferences, and so on) are to be as fully considered as medicine's science when formulating treatwith the science, then it is the values which remain preeminent and which form the basis of decision-making. Importantly, patient-centered medicine has been criticized as an overly consumerist model of care, where the patient is empowered as a customer and the clinician is disempowered into a simple provider of goods [1][2][3][4][5][6][7][8][9][10] . In direct contradistinction, the EBM movement has aimed principally at accelerating the introduction of scientific evidence into "hands on" practice in the clinic and at the bedside, but being preoccupied with biostatistics (and traditionally viewing these as pre-eminent above patients' subjectively expressed needs) has gravely neglected the humanistic character of medicine 1-10 , resulting in the range of unintended consequences for medicine's humanism that EBM leaders now themselves openly acknowledge 29,30 .…”

“…Any coalescence will -constitution, to move from epistemological foundationalism to epistemological non-foundationalism and thus from a scientific evidence-based stance (EBM), to a scientific evidence-informed position (EIM). For this reason, and to make progress towards the development of new clinical methods to deal far more effectively with the current epidemic of multi-morbid, socially complex long term illness, Miles and Asbridge have called for the "collapse" of the vertically ordered "Hierarchy of Evidence" of EBM into a horizontally ordered "Library of Clinical Knowledge Sources" which -ical knowledge of relevance to clinical decision-making and from which the wise clinician can draw, as indicated, with -tient [1][2][3][4][5][6][7][8][9][10] .…”

“…Indeed, it has been contended that if modern Society continues to tolerate this crisis of disregard sad juncture in human history indeed [4][5][6][7] . So what is to be done?…”