Carolinas HealthCare System leaders have developed a team-based approach to effectively address patient experience through shared decision-making.
This article appears in the June 2014 issue of HealthLeaders magazine.
The term patient-centered care has had an unfortunate misinterpretation for many in healthcare. Some providers end up building teams and processes around the patient at the expense of those who work with the patient. The team at Carolinas Medical Center-Mercy understood the relationship between doctor and patient historically has been paternalistic, with the physician as expert directing care based on his or her view of what is best for the patient. Providers have generally moved past that model, but few have embraced a true collaborative model in which the physician and patient each bring their knowledge, says Hazel Tapp, PhD, associate director of research for the Department of Family Medicine at Carolinas Medical Center-Mercy.
"Shared decision-making is a meeting of two experts," Tapp says. "The patient is the 100% expert on what's important to them and their preferences. And the provider brings expertise around disease knowledge and psychosocial situations."
Dael Waxman, MD, interim chair of the Department of Family Medicine at Carolinas Medical Center-Mercy, says this approach is really about helping the patient make decisions about what is best for him or her.
"Shared decision-making says the physician is the expert on the disease and about what needs to happen to treat the disease," Waxman says. "The patient is the expert [on] what they're willing to do, what they can afford to do, what makes them happy, what's distasteful to them. In the middle, we're going to have a conversation about what the patient is going to do. The physician may have some suggestions, but the patient is the one that's going to walk away with it."
Jim Molpus is Interim Editor in Chief and Leadership Programs Director for HealthLeaders.