[Patient centered medicine--a review with emphasis on the background and documentation].
BACKGROUND
In this paper we present the patient centred clinical method from a historical viewpoint with emphasis on its philosophical and ethical foundations. The paper reviews the documentation and discusses the relevance of the method.


METHODS
Literature review.


RESULTS
The patient centred method was introduced in western clinical medicine as a result of a general shift in science and the introduction of systems theory and relational understanding. The ethical basis for the method is humanistic values with emphasis on respect and mutuality in human relations. Observational studies suggest that the method improves outcome for patients. Experimental evidence is sparse and conflicting. The concept of patient centredness is vague with regard to the management phase of consultations. The relationship between doctor-patient communication, the concept of patient centredness, patient satisfaction, empowerment and outcome needs further clarification and research.


CONCLUSIONS
Clinical medicine has to encompass the personal and relational level of human life in order to help and guide patients. The patient centred method demonstrates how this can be achieved during the diagnostic phase of the consultation. We need, however, firmer knowledge and ethical consideration of how management negotiations may empower patients and improve their outcome.
Meland
E
E
Seksjon for allmennmedisin, Universitetet i Bergen. Eivind.Meland@isf.uib.no
Schei
E
E
Baerheim
A
A
D003142:Communication; D004282:Documentation; D004992:Ethics, Medical; D006808:Humanism; D006801:Humans; D010686:Philosophy, Medical; D010817:Physician-Patient Relations; D012017:Referral and Consultation / Q000592:standards; D016896:Treatment Outcome