Reframing Clinical Paradigms: Strategies for Improving Patient Care Relationships

Abstract

This article presents strategies for reframing clinical paradigms to build better therapeutic relationships with patients and the members of their support network from the unique and important lens of a parent and disability researcher. First, a brief history of the evolution of models of care is presented and implementation of the current biopsychosocial model is discussed. Then, evidence-based practice and the role of the patient perspective is considered. Next, specific examples, tools, techniques, guidelines, and resources to foster the demonstration of patient-informed respect and patient-centered communication in clinical practice are provided. Examples and resources are presented that can be accessed and implemented immediately, without a cost to the practitioner, and with the vast potential to improve care, therapeutic relationships, and patient outcomes. It is important for health care providers and researchers in all practice areas and across all experience levels to regularly evaluate their psychosocial skills. It is critical that the voices of patients and the members of their support network are central in this process. This can enable health care providers to acknowledge areas for growth and to implement changes effectively and efficiently at the individual level in order to facilitate changes across the broader spectrum of health care practice.

Implementing a Dutch Physical Therapy Intervention Into a U.S. Health System: Selecting Strategies Using Implementation Mapping

“…Training components that improve implementation include multiple exposures, interactivity, longer training periods, and focusing on outcomes important to clinicians ( 33 , 34 ). Specific to physical therapy, reflection, simulations, self- and peer-assessment improve self-efficacy and commitment to behavior change ( 35 – 37 ). Deliberate practice and structured feedback facilitates changes in person-centered communication ( 38 ).…”

“…Person-centered care is a critical component in improving health behaviors and clinical outcomes in patients with chronic MSK conditions ( 15 , 50 , 51 ). Successful delivery requires understanding the patient as a whole and adapting to the patient's disease experience ( 35 ). Physical therapists acknowledge the need for a person-centered approach to care but continue to have difficulty implementing many components of person-centered care ( 22 ).…”