The precarious future of the discourse of person-centered medicine

Abstract

Discourses are more than just patterns of words. For discourse communities, they express ideologies and provide meanings that can be translated into action. They are vehicles for reform when they thrive. The discourse of person-centered medicine has had a vigorous start, with identifiable leaders, a vocabulary which has situated meanings, institutions such as meetings, letterheads and a Society and a group of adherents that constitute a discourse community. For a discourse to thrive, its founding problematic has to be perceived as 'real' by its target audience -in this case, presumably, healthcare workers. Real in this sense can be defined as something perceived to have an influence on foundational values, for better or for worse. It is not yet clear that the discourse of person-centered medicine has convinced its target audience of the 'crisis of knowledge, care, compassion and costs' that it invokes to justify its proposed paradigm shift. In order to make it thrive, those who drive the discourse will need to 'realise' both the crisis it addresses and the outcomes it may achieve.

Beyond the Point of No Return: A Discourse Analysis of Healthcare Professionals’ Perceptions of Digitally Supported Person-Centred, Integrated, and Proactive Care

“…The identified discourses illustrate that, despite challenges and concerns, the vision of Digi-PIP was strongly embedded among all the professionals in this study. Consistent faith in digitalisation, PCC, and integrated and proactive care across professions and healthcare contexts is surprising and contested by established literature [30,31], including the framework litterature [10,25,26,27,28,29]. Uncontested optimism is mainly found in policy discourses and the technology industry.…”

“…The second component, PCC, has been a prevailing discourse in healthcare for several decades, contrasting with the bio-medical paradigm in which patients are seen as passive recipients of medical interventions [10]. It argues that patients are persons whose health, illness, well-being, hopes, and needs are intertwined with their environment.…”

“…Inspired by Fairclough [14], we explored the discourse literature and theoretical perspectives we found most relevant to Digi-PIP care, such as digitalisation, PCC, and integrated and proactive care [10,24,[26][27][28]32]. We shaped the key findings from this literature into a framework that we used (Table 1) for the data analysis.…”

“…Therefore, innovative solutions are required. The principles of digitally supported person-centred, integrated, and proactive (Digi-PIP) care make up the most ambitious initiatives, according to Berntsen et al [2] Digitalisation and the transformation from organisation-to person-centred care (PCC) are prevailing policy discourses regarding the modernisation of healthcare provision in recent decades [10,11]. There is also a strong, common-sense belief that Digi-PIP care is a key component of sustainable healthcare [2].…”

A Better Grounding for Person-Centered Medicine?

“…Thus, medical professionals view with some skepticism the attempts at qualitative reform, and this is the fourth problem for qualitative reform. To shift the nature of a discourse, the target audience has to perceive that there is a real issue at stake (Little 2012). EBM provides a good example.…”