Plan ahead: How neurologists can enhance patient-centered medicine

A defining characteristic of American medicine at the turn of the 21st century is the replacement of the physician-centered model of care with the patient-centered model. Patient-centered care is health care that is congruent with and responsive to the wants, needs, and preferences of patients.1 Although some physicians would take umbrage at this distinction and assert that the patient always has been the focus of medical care, in the past, the prerogatives and preferences of physicians more often were afforded primacy than those of patients. Patient-centered medicine has evolved in the context of the patients’ rights movement, particularly the increased recognition of patients’ ethical and legal rights to participate in all medical decision making that affects them. The growing emphasis on respecting the doctrine of informed consent exemplifies this evolution. The currently accepted model of the process of medical decision making is known as “shared decision making.” In the shared decision-making model, the clinician contributes specialized knowledge, training, and experience regarding medical diagnosis, prognosis, and treatment options and …