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Mind the Gap – Patient-Centered Diagnostic Excellence

December 6, 2021

Talking about race in EM

Today’s article summary is below but first a quick announcement. We are planning a “town hall” podcast with the four authors of the recent Annals of EM op-ed – Dear White People in Emergency Medicine, and you are asking the questions! Talking together as friends and colleagues is powerful. Nick Z., Eriny, and I will curate your questions and comments and present this podcast to you in early 2022. Submissions are anonymous. Let’s be curious, kind, and learn how we can better care for each other. ~Clay

Please drop your questions for this town hall into this Google Form.


Written by Megan Hilbert

Spoon Feed
A recent opinion piece published in JAMA reminds us all that patient-centeredness is not just a term to be quoted in a hospital’s mission statement.

Why does this matter?
Not infrequently, the physicians’ and patients’ goals of a medical encounter are misaligned. While the physician is often most concerned with making the diagnosis, the patient may be more concerned with addressing pain or emotional distress. This article encourages healthcare providers to cross that divide.

“MD is not greater than ME” – All patients everywhere
Patient centeredness gained traction in 2001 with “Crossing the Quality Chasm” by the Institute of Medicine. This current article focuses on the application of this principle in the diagnostic process – reminding healthcare providers that “getting the right answer” is simply not enough. We also need to focus on:

  1. Valuing our patient’s vigilance – often they identify issues long before we do

  2. Arranging appropriate follow up – what good is a diagnosis without further management?

  3. Remembering that not all things we do in Medicine are benign. Make sure to take the patient’s discomfort, time, and cost of services into account.

  4. Remembering our duty to help patients understand their diagnosis. This means making sure to explain in a way that is understandable.

  5. Finally, doing our best to integrate clinical findings into the patient’s cultural circumstances, knowledge-base, and socio-economic capabilities. After all, no one lives in a bubble.

While these are all things we have heard before, I encourage all readers to take a moment and reflect – is your practice truly patient-centered? And if not, what steps can you take to improve? Your patients will thank you for it.

Diagnostic Excellence Through the Lens of Patient-Centeredness. JAMA. 2021 Nov 18. doi: 10.1001/jama.2021.19513. Online ahead of print.

What are your thoughts?