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Show eliminating the depersonalization of the patient and improving patient care. Redefining the Role of the Patient Rather than being passive recipients of medical care, patients need to be accepted as "full partners" in the healing process. The whole patient must be considered, and the patient needs to be considered in context (DiMatteo & DiNicola, 1982). "[P]atient-as-partner programs can improve the quality of care, reduce costs, add to provider profits, increase patient satisfaction, [and] contribute useful marketing intelligence..." (Martin, Hunt, Hughes-Stone, & Conrad, 1990). When confronted by stressful events, every individual utilizes some sort of coping mechanism. Such coping efforts have limited success within an organizational structure "that promotes depersonalization and loss of control. What is implied as a solution to this problem is an informed-participant role for the patient" (Taylor, 1982). Patients should be allowed to assume control over those aspects of their care that they can control. In those aspects of care which they cannot manage alone, patients should at least be allowed to participate. This action will help maintain patients' dignity and acknowledge their maturity. They are not reduced to helplessness. By playing an active role in their healing process, patients can be much better informed and can become much more in touch with their own bodies. Some patients, however, do not wish to become active participants in their healthcare. While some individuals want to know all of the details, there are many patients who just want a pill or a treatment and do not care to know the details. Healthcare workers need to assess every patient on any individual basis and determine the extent to which each patient can adopt an informed-participant role. Open communication channels with the physician are an important element for even the most minimal patient participation. The communication between the physician and the patient should include not only a physiological background (i.e., the complaint or injury), but also a social and psychological background (e.g., family, employment, hobbies). By understanding the context in which each individual patient works and lives, healthcare providers can better treat the whole person. They can treat causes and not just symptoms. The greatest drawback to such detailed care, however, is that it takes time. It need not be used in emergency medical care, but the additional time spent during routine consultations serves to strengthen the doctor-patient relationship and "improves both the process and the subsequent outcome of care" (Delbanco, 1992). Cooperative-Care: The Planetree Model A few pioneering hospitals have begun to utilize new models of healthcare which emphasize the treatment of patients as "independent, autonomous partners in their own care and controllers of their own destiny" (Chapman, 1990). The Planetree Model Hospital Project, begun at San Francisco's Pacific Presbyterian Medical Center in 1985, is one such example of cooperative-care, and it includes virtually every aspect of improved, customer-oriented, patient-centered care discussed in this paper. The goals of the Planetree Project are simple, but significant. Its goals are: "to humanize health services, to provide consumers with access to information, and to empower consumers to take charge of their own health" (Coile, 1990). Planetree emphasizes "compassion, comfort, aesthetic beauty, dignity, shared knowledge, and the freedom of informed choice" (Weber, 1992). In order to accomplish these goals, Planetree began by changing the environment in which patients receive care (Martin, et al., 1990; Coile, 1990; Chapman, 1990; Weber, 1992). A standard hospital unit was redesigned and then transformed into a more homelike, tranquil environment. Patients and their families have access to a kitchenette 86 WHAT ABOUT THE PATIENT? |