Those charged by the ACA health reform act to identify best clinical practices that are evidence-based and applicable across diverse populations can learn much from the experience of the Medicare-funded End Stage Renal Disease Program.
The causes of many health behaviors are deeply rooted in our culture, and using a counseling model that assumes individual control and responsibility for these behaviors can cause patients to feel hectored instead of helped.
“Difficult” patient-physician encounters have roots in uncertainty about individuals’ trustworthiness, clinicians’ skills and training, and medical science.
AMA J Ethics. 2017;19(4):391-398. doi:
10.1001/journalofethics.2017.19.4.mhst1-1704.
Invention of the stethoscope in 1816 changed the patient-physician relationship. Technology, widely used in medicine today, is not a substitute for the physician’s human understanding of the patient’s life.