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PCCM - Patient-Centered Clinical Method

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PCCM- Patient-Centered Clinical Method

The Patient-Centred Clinical Method is a model for the Doctor-Patient Interaction


in Family Medicine.

Why Do We Bother With PCCM?

This is because research evidence supports findings that the patient-centred


clinical method:

• Enhances patient satisfaction

• Improves patient outcomes

• Has a positive impact on health care utilization costs

• Is associated with positive benefits in practice, such as greater job satisfaction

• Is associated with decreased diagnostic testing and referrals

• Is associated with fewer malpractice claims

The Patient-Centred Clinical Method Has Six Interactive Components Which We


Could Compress to Four using the mnemonic EPGR. They include:

Exploring the patient's main reason for the visit, concerns, and need for
information- The disease versus illness experience.

Seeking an integrated understanding of the patient's world that is, their whole
person, emotional needs, and life issues, their personality.

Finding a common ground on what the problem is and mutually agreeing on


management.

Enhancing the continuing relationship between the patient and the health provider.
This may trickle down into these last two:

Establishing prevention and health promotion concepts with all encounters.

Being realistic in practice


DISCUSSING THESE IN MORE DETAILS:

1. Exploring both the disease and the illness experience:

Taking history, physical examination, lab investigations.

Checking the dimensions of illness (feelings, ideas, effects on function and


expectations).

2. Understanding the whole person:

Looking into the person (e.g. life history, personal and developmental issues);

Inspecting the proximal context (e.g. family, employment, social support);

Inspecting the distal context (e.g. culture, community, ecosystem).

3. Finding common ground:

Determining the problems and priorities.

Establishing goals of treatment and/or management.

Defining the roles of the patient and the health care professionals.

4. Enhancing the patient-health care professionals‛ relationship:

Entertain compassion; Share power; Ensure healing; and Be self-aware (be alive to
the concepts of transference and counter-transference). Relationships require
time and continuity for:

5. Incorporating prevention and health promotion: health enhancement; risk


avoidance; risk reduction; early identification; and complication reduction.

6. Being realistic is important for growing this relationship, teambuilding and


teamwork.
A pictorial of this discussion is as seen below:

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