Why has the concept of patient-centred care failed?
This chapter examines the concept of patient-centred health care in detail. Patient-centred care is the stated prevailing ethos of health service provision, yet the evidence indicates that this attitude has been extremely difficult to incorporate into routine clinical practice in which decisions are generally made by the health professional rather than the patient. The origins of patient-centred care are considered, and empirical evidence of the failure of patient-centred care is provided. Indicators that health care is delivered from the perspective of the treating health professional rather than the treated patient are bountiful and long-standing. Terms such as “treatment resistant”, “treatment dropout”, and “non-compliant” or “non-adherent” are commonplace. These terms illustrate judgements made by health professionals that ignore the perspective of the patient. Other examples are provided throughout the chapter such as the tension between accommodating individual patient’s perspectives and satisfying demands at a health systems’ level. The chapter emphasises that it is the perspective of the patient rather than their geographical position that is critical to the delivery of appropriate care on a routine basis.