Being well and wellbeing: Better understanding of patient priorities in primary care

Abstract

Introduction: Achieving desired health outcomes in primary care can be challenging because of dissonance between the theory and reality of medicine, inadequate understanding of patient perspectives and priorities regarding wellness, wellbeing and goals of treatment, and under-emphasis of the concept of whole-person care in the doctor-patient relationship. Assessment of Problems: Anticipated dissonance in the doctor-patient relationship was explored using a self-designed audit, which also functioned as an educational and engagement tool. Over a 12-month period, 282 adult patients (aged 24-94 years) provided responses to a question asking them to describe their best day in the context of their current health status. These responses were then entered into the Classifications field of the practice's patient management system. Results of Assessment: Most respondents appreciated the opportunity, with a small number commenting on the challenging nature of the question. Strategies for Quality Improvement: Entering audit findings into the patient's clinical record in a format accessible to all clinical staff enables increased opportunity for patients to be valued and engaged with. Goal setting and therapeutic choices can be made in the light of a better understanding of what matters most to the patient. Lessons and Messages: This project provided valuable and, at times surprising, information to clinical consultations that had not previously been obtained from or offered by patients. Such information requires an intentional, engaged and collaborative interaction with the patient, and enhances patient-centric consultations with a focus on whole-person care and wellness in the journey to therapeutic goals and health outcomes.