Reconsidering Patient Centred Care: Between Autonomy and Abandonment

Alison Pilnick's book "The Patient as Consumer: Reforming Patient-Centred Care" challenges the conventional understanding of patient-centered care (PCC) by demonstrating that it is not always effective in improving health outcomes. Pilnick's research shows that PCC is often undermined by organizational and interactional factors,such as the sidelining of medical expertise. She argues that reform should focus on re-centering medical expertise in contemporary healthcare and that values-driven policy can be problematic in practice.

Format: Hardback
Length: 216 pages
Publication date: 23 August 2022
Publisher: Emerald Publishing Limited

Winner of the Foundation for the Sociology of Health and Illness Book Prize 2023

In a groundbreaking contribution to the sociology of medicine, Alison Pilnick redefines the discourse surrounding patient-centered care (PCC). Traditionally perceived as a moral obligation, PCC is believed to be essential in preventing a resurgence of outdated medical paternalism. However, empirical evidence consistently fails to establish a clear correlation between the adoption of PCC and improved health outcomes. This failure is often attributed to professional shortcomings, leading to calls for enhanced training in PCC. Consequently, empirical research primarily focuses on measuring the extent to which healthcare practices fall short of meeting PCC criteria.

Through a comprehensive analysis of a vast corpus of healthcare interactions spanning a quarter-century, Pilnick unveils the underlying organizational and interactional factors that may appear to contradict PCC principles. Conceptualizations of PCC often prioritize patient autonomy, emphasizing individuals' ability to make choices and exert control. However, the analysis presented here challenges the consumerist underpinnings of PCC, highlighting the potential drawbacks and unintended consequences of attempting to implement these ideals. It underscores how the pursuit of patient autonomy can inadvertently sideline medical expertise that patients seek or require.

Arguing for a reform that aims to re-center medical expertise in contemporary healthcare, the analysis illustrates why values-driven policy can be challenging in practice. It emphasizes the importance of utilizing analyses of healthcare interactions as a foundation for healthcare policymaking, rather than solely as a metric for evaluating its success. By adopting this approach, policymakers can gain a deeper understanding of the complexities and nuances of healthcare interactions, leading to more informed and effective policy decisions.

The Foundation for the Sociology of Health and Illness Book Prize 2023 recognizes Alison Pilnick's significant contribution to the field, highlighting her ability to challenge prevailing paradigms and advocate for a more patient-centered approach to healthcare. Her work sheds light on the complexities and challenges inherent in healthcare delivery, and provides valuable insights for policymakers and practitioners seeking to improve patient outcomes and enhance the quality of healthcare services.

Weight: 374g
Dimension: 160 x 241 x 15 (mm)
ISBN-13: 9781800717442