Patient-Centredness Without a Centre

Abstract

`Patient-centeredness' is a relatively new term in the medical lexicon. Yet it has become a mantra, expressed often and with little critical attention. For this reason, we might aspire to an `authentic' patient-centeredness---as a patient-centeredness-to-come. And for this aspiration to become reality, we must shift medical culture from autocratic to democratic habits, to achieve a mutuality of care. Such mutuality in care benefits patients and so should be taught as an integral part of a medicine curriculum. However, first we must conceptualize `patient-centeredness' as there are many varieties to this approach. I suggest a patient-centeredness without a centre, where mutually enhancing conversation is the ideal model. This recognizes both the doctor's and the patient's expertise within a narrative mode of care, with attention to, and tolerance of `difference' as the key factor.