
PCM (patient centered medicine) is a buzz word in medical schools these days. The basic theory of PCM is to make the medical experience as pleasant as possible for the patient by approaching health issues in a way the patient feels most comfortable. The idea allegedly improves patient compliance and satisfaction, leading to improved medical outcomes in general. The concept has medical school curriculum writers drooling in anticipation of the neat programs they can implement to ensure their students are oozing with patient centered-ness by the time they graduate.
Today I participated in one such course as I conducted my first ever "patient centered" medical history interview. Although this wasn't the real deal (I was interviewing a standardized patient in a mock examination room), I was still a bit nervous. A very real instructor was critiquing my attempt at playing doctor, so I wanted to put on a good show. I tried to focus on being especially patient centered as I began gathering the basic background information, and threw in some nice rapport-building comments for good luck. I sweat my way through the touchier subjects, but once I finished I thought I had done well enough. And I had, for the most part.
My instructor (and the standardized patient) kindly informed me that telling a patient they are the same age as my mother doesn't fit under the umbrella of "patient centered", even if I was just trying to build rapport. First, it probably makes them feel old. Second, they will probably freak out and think, "this kid isn't old enough to prescribe medications." So I've learned my lesson. Patient centered medicine is still a nebulous art that will take some practice to perfect. And I can only tell patients they are the same age as my mother if they are over 94.