The Patient-Centered Medical Home: An Ethical Analysis of Principles and Practice

Braddock, Clarence H.; Snyder, Lois; Neubauer, Richard L.; Fischer, Gary S.

doi:10.1007/s11606-012-2170-x

Cited by 20 publications

(12 citation statements)

References 18 publications

(11 reference statements)

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“…The healthcare professional as a consociate acknowledges the need to know the patient better to assemble an appropriate support team. By seeing the patient as an integral person, the healthcare team member is now in a position to consider the broader impact of health information, not only on the patient’s physical health but also in other dimensions of the patient’s life [ 34 ]. The healthcare professional as a consociate can better identify the moral, economic, and social implications of the disease process for the patient’s health and wellbeing ( Fig 6 ).…”

Section: Resultsmentioning

confidence: 99%

Today´s medical self and the other: Challenges and evolving solutions for enhanced humanization and quality of care

et al. 2017

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BackgroundRecent scientific developments, along with growing awareness of cultural and social diversity, have led to a continuously growing range of available treatment options; however, such developments occasionally lead to an undesirable imbalance between science, technology and humanism in clinical practice. This study explores the understanding and practice of values and value clusters in real-life clinical settings, as well as their role in the humanization of medicine and its institutions. The research focuses on the values of clinical practice as a means of finding ways to enhance the pairing of Evidence-Based Medicine (EBM) with Values-based Medicine (VBM) in daily practice.Methods and findingsThe views and representations of clinical practice in 15 pre-CME and 15 post-CME interviews were obtained from a random sampling of active healthcare professionals. These views were then identified and qualitatively analyzed using a three-step hermeneutical approach.A clinical values space was identified in which ethical and epistemic values emerge, grow and develop within the biomedical, ethical, and socio-economic dimensions of everyday health care. Three main values—as well as the dynamic clusters and networks that they tend to form—were recognized: healthcare personnel-patient relationships, empathy, and respect. An examination of the interviews suggested that an adequate conceptualization of values leads to the formation of a wider axiological system. The role of clinician-as-consociate emerged as an ideal for achieving medical excellence.ConclusionsBy showing the intricate clusters and networks into which values are interwoven, our analysis suggests methods for fine-tuning educational interventions so they can lead to demonstrable changes in attitudes and practices.

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Section: Resultsmentioning

confidence: 99%

Today´s medical self and the other: Challenges and evolving solutions for enhanced humanization and quality of care

et al. 2017

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“…In a position paper in this month's Journal, 2 the American College of Physicians (ACP) Professionalism, Ethics and Human Rights Committee begins to address these issues, opening a crucial conversation by asking the question: Does the PCMH promote Beauchamp and Childress' four core principles of medical ethics (namely: respect for autonomy, beneficence, nonmaleficence and justice)? 3 To answer this question, the Committee compared the Joint Principles of the Patient Centered Medical Home, developed by the ACP and several other primary careoriented specialty groups, 4 and a similar set of "key attributes" of patient-centered primary care, with the four principles of medical ethics.…”

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confidence: 99%

Ethical Challenges Come Home

Wynia

Sabin

2012

J GEN INTERN MED

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“…[22][23][24] Patient-centered care emphasizes the importance of patientclinician communication, shared decision making, and respect for patient preferences. 25 Patient-centered care aligns with the core principles of medical ethics 26 and has been associated with improvements in patient satisfaction, adherence, and selfmanagement 27 . Understanding survivors' preferences can help clinicians deliver patient-centered care.…”

Section: Introductionmentioning

confidence: 99%

Understanding Long-Term Cancer Survivors’ Preferences for Ongoing Medical Care

Smith

Strollo

Hu³

et al. 2019

J GEN INTERN MED

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BACKGROUND: Due to risk for treatment-related late effects and concerns about cancer recurrence, long-term cancer survivors have unique medical needs. Survivors' preferences for care may influence adherence and care utilization. OBJECTIVE: To describe survivors' preferences for care and factors associated with preferred and actual care. DESIGN: Cross-sectional analysis of participants in a longitudinal study using mailed questionnaires. PARTICIPANTS: Survivors of ten common cancers (n = 2,107, mean years from diagnosis 8.9). MAIN MEASURES: (1) Survivors' preferences for primary care physician (PCP) and oncologist responsibilities across four types of care: cancer follow-up, cancer screening, preventive health, and comorbid conditions. (2) Survivor-reported visits to PCPs and oncologists. KEY RESULTS: The response rate was 42.1%. Most longterm survivors preferred PCPs and oncologists share care for cancer follow-up (63%) and subsequent screening (65%), while preferring PCP-led preventive health (77%) and comorbid condition (83%) care. Most survivors (88%) preferred oncologists involved in cancer follow-up care, but only 60% reported an oncologist visit in the previous 4 years, and 96% reported a PCP visit in the previous 4 years. In multivariable regressions, those with higher fear of cancer recurrence were less likely to prefer PCP-led cancer follow-up care (OR = 0.96, CI = 0.93-0.98), as did survivors with advanced cancer stage (OR = 0.56, CI = 0.39-0.79). Those with higher fear of recurrence (OR = 1.03, CI = 1.01-1.04) or who preferred oncologist-led cancer follow-up care (OR = 2.08, CI = 1.63-2.65) had greater odds of seeing an oncologist in the last 4 years. CONCLUSIONS: Most cancer survivors preferred PCPs and oncologists share care for cancer follow-up and screening, yet many had not seen an oncologist recently. Survivors preferred PCP-led care for other preventive services and management of comorbid conditions. These findings highlight the important role PCPs could play in survivor care, suggesting the need for PCP-oriented education and health system policies that support highquality PCP-led survivor care.

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The Patient-Centered Medical Home: An Ethical Analysis of Principles and Practice

Cited by 20 publications

References 18 publications

Today´s medical self and the other: Challenges and evolving solutions for enhanced humanization and quality of care

Today´s medical self and the other: Challenges and evolving solutions for enhanced humanization and quality of care

Ethical Challenges Come Home

Understanding Long-Term Cancer Survivors’ Preferences for Ongoing Medical Care

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