Patient-centered care only a good first step

Though the maxim "First, do no harm" is not, as popularly thought, part of the Hippocratic oath that doctors swear, it is still an underlying principle of medical education.

Until recently, few in the profession seemed to acknowledge that the cold, impersonal and dehumanizing hospital experience could alone constitute "harm."

But as competition for patients grows more acute, suddenly hospitals are listening to patients. Instead of ignoring their complaints, medical care practitioners are becoming "patient-centered" and have engaged whole families rather than relegating them to visiting hours and ignoring their requests for information.

That all medical practitioners haven't always been "patient-centered" is shocking enough. That they have to hire consultants to learn how to do it, as some have done, is even more shocking.

"I think it's very easy for (doctors) to think about the health care system from our own perspective rather than from the eyes of patients," said Stephen Schoenbaum, of the Commonwealth Fund, a private foundation that advocates for better health care.

We can only hope the new philosophy has trickled down to medical schools in the form of classes in bedside manner and effective doctor-patient relationships, along with a requirement that students prove they have these skills before serving patients.

Yes, research seems to indicate that the experience in a hospital can help or hinder a patient's recovery as much as the science being practiced. But consumers still shouldn't forget the change in attitude is as much about money as it is about humanity. In the highly competitive market for patients, fighting the expansions of competitors has become as normal as not. Seeking to please consumers is a far more productive reflection of the very same battle.

With hospitals moving toward a "patient-centered" universe, the next step ought to be not shocking those patients back into ill health upon receipt of their bills.

Medicine remains one of the few areas where consumers have no idea what the final bill might be before they decide whether to use those services or not. Patients deserve far better than that.

While we understand it is difficult to foresee all expenditures and diagnostic changes that might alter them, there's still no reason a published price list isn't available for various procedures. And there's even less reason for a particular procedure to cost thousands of dollars more or less, based on the insurance coverage of the patient or the lack thereof. In the medical field, someone who wants to pay cash often is charged far more than those with insurance. In most any other field, such varied charges would be called discriminatory.

So yes, the "patient-centered" care trend is a boon to consumers. But the health care industry still has a long way to go before it can be considered a trusted member of the family.