The philosophy of patient-centred care (PCC) underpins the delivery of much healthcare globally. PCC is typically framed as a moral imperative, necessary to prevent a return to the outmoded medical paternalism of the past. However, empirical research repeatedly fails to show a clear link between the adoption of PCC and improvement in health outcomes. These results are largely considered as professional failings, to be remediated through more or 'better' training in PCC.
In this talk, I will draw on research based on a large corpus of healthcare interactions collected over 25 years from a range of settings. Conceptualisations of PCC typically foreground the importance of patient autonomy, to be exercised through choice and control; my analysis will highlight the problems with these consumerist underpinnings of PCC, and show how the interactional consequence of attempting to enact them is often the sidelining of medical expertise that patients want or need.
This work highlights the importance of using analyses of healthcare interaction to inform healthcare policymaking at the outset, rather than simply as a barometer of its success.
Alison Pilnick is Professor of Language, Medicine and Society at the Faculty of Social Sciences at the University of Nottingham. Her research interests lie primarily in the field of the sociology of health and illness, with a particular interest in interactions between health and social care professionals and their patients or clients. She has worked with a wide range of health professionals in a wide range of care settings both in the UK and overseas, using audio and video recordings to examine interactions and to inform and develop communication skills training. This is linked to a broader interest in the use of qualitative methods in sociological research.
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