chapter  2
26 Pages

Clinician care of the patient

Health care systems depend heavily on the delivery of patient care by clinicians, including physicians and other qualified health care professionals. Patient ‘care’ is used here as a portmanteau term describing values and technical and interpersonal practices by clinicians.1 Technical performance relates to their service provision for patient welfare, whilst interpersonal behaviour adds concerned attention – that is, caring – for patient welfare. I intend to convey both meanings in mapping the myriad factors that blunt the ability of patient-centredness to provide health care to patients. The chapter begins by defining patient centred health care and critically discussing core features of its historical and contemporary landscape, including a commitment to moral principles of health care professionalism such as primacy of patient welfare. I then discuss how four sets of characteristics of modern health care are testing clinicians’ professional commitment and ability to implement this principle, among others, in order to practise patient-centred health care – on whose ‘watch’ the challenges to this care model have been permitted to expand. The result is an unmet need for health systems to improve the organization and delivery of clinician care for patient welfare. In common with Chapters 3 to 5, this chapter underpins my discussion of the need for person-centred health care in Part II of the book.