Patient-centered care focuses on the patient and the individual’s particular health care needs. The goal of patient-centered health care is to empower patients to become active participants in their care.

Patient-centered care has now made it to center stage in discussions of quality. The originators of client-centered and patient-centered health care were well aware of the moral implications of their work, which was based on deep respect for patients as unique living beings, and the obligation to care for them on their terms. Thus, patients are known as persons in context of their own social worlds, listened to, informed, respected, and involved in their care—and their wishes are honored (but not mindlessly enacted) during their health care journey.There have been concerns that patient-centered care, with its focus on individual needs, might be at odds with an evidence-based approach, which tends to focus on populations. Fortunately, that debate has been laid to rest; proponents of evidence-based medicine now accept that a good outcome must be defined in terms of what is meaningful and valuable to the individual patient.⁷ Patient-centered care, as does evidence-based medicine, considers both the art of generalizations and the science of particulars.

Patient-centered care is a quality of personal, professional, and organizational relationships. Thus, efforts to promote patient-centered care should consider patient-centeredness of patients (and their families), clinicians, and health systems. Helping patients to be more active in consultations changes centuries of physician-dominated dialogues to those that engage patients as active participants. Training physicians to be more mindful, informative, and empathic transforms their role from one characterized by authority to one that has the goals of partnership, solidarity, empathy, and collaboration. Systems changes that unburden primary care physicians from the drudgery of productivity-driven assembly-line medicine can diminish the cognitive overload and exhaustion that makes medical care anything but caring or patient-centered.

Confusion about what patient-centered care really means, however, can produce efforts that are superficial and unconvincing. In the name of patient-centeredness, hospitals have been adopting models used by boutique hotels with greeters, greenery, and gadgetry. Although such amenities might enhance the patient’s experience, they do not necessarily achieve the goals of patient-centered care. Calls for patient-centered care have often emphasized the implementation of infrastructural changes. These changes, such as electronic health records and advanced access scheduling, may be necessary to move medical care into the 21st century, but they should not be conflated with achieving patient-centered care. Simply implementing an electronic health record in itself is not patient-centered unless it strengthens the patient-clinician relationship, promotes communication about things that matter, helps patients know more about their health, and facilitates their involvement in their own care. Similarly, advanced access scheduling could as likely lead to greater access to an overworked, uncaring functionary as it could to a familiar and caring presence in time of need.