Skip to main content

Main menu

  • Home
  • Articles
    • Current
    • Published Ahead of Print
    • Archive
    • Supplemental Issues
    • Collections - French
    • Collections - English
  • Info for
    • Authors & Reviewers
    • Submit a Manuscript
    • Advertisers
    • Careers & Locums
    • Subscribers
    • Permissions
  • About CFP
    • About CFP
    • About the CFPC
    • Editorial Advisory Board
    • Terms of Use
    • Contact Us
  • Feedback
    • Feedback
    • Rapid Responses
    • Most Read
    • Most Cited
    • Email Alerts
  • Blogs
    • Latest Blogs
    • Blog Guidelines
    • Directives pour les blogues
  • Mainpro+ Credits
    • About Mainpro+
    • Member Login
    • Instructions
  • Other Publications
    • http://www.cfpc.ca/Canadianfamilyphysician/
    • https://www.cfpc.ca/Login/
    • Careers and Locums

User menu

  • My alerts

Search

  • Advanced search
The College of Family Physicians of Canada
  • Other Publications
    • http://www.cfpc.ca/Canadianfamilyphysician/
    • https://www.cfpc.ca/Login/
    • Careers and Locums
  • My alerts
The College of Family Physicians of Canada

Advanced Search

  • Home
  • Articles
    • Current
    • Published Ahead of Print
    • Archive
    • Supplemental Issues
    • Collections - French
    • Collections - English
  • Info for
    • Authors & Reviewers
    • Submit a Manuscript
    • Advertisers
    • Careers & Locums
    • Subscribers
    • Permissions
  • About CFP
    • About CFP
    • About the CFPC
    • Editorial Advisory Board
    • Terms of Use
    • Contact Us
  • Feedback
    • Feedback
    • Rapid Responses
    • Most Read
    • Most Cited
    • Email Alerts
  • Blogs
    • Latest Blogs
    • Blog Guidelines
    • Directives pour les blogues
  • Mainpro+ Credits
    • About Mainpro+
    • Member Login
    • Instructions
  • RSS feeds
  • Follow cfp Template on Twitter
LetterCorrespondance

Patient-centred approach is the way

Tom R. Freeman
Canadian Family Physician December 2014, 60 (12) 1081;
Tom R. Freeman
London, Ont
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • Article
  • eLetters
  • Info & Metrics
  • PDF
Loading

I thank Hudzik and colleagues for drawing attention to the Choosing Wisely Canada campaign.1 Hudzik et al make the point that while general guidelines are helpful, decisions on investigations must take into account the individual circumstances of each case and recognize that “the choice of diagnostic and therapeutic modalities might not be the same for any 2 patients, even those with the same condition.”1 This is salutary but leaves open the question of how unnecessary test ordering can be reduced in daily practice.

Instituting a patient-centred clinical method2 has been shown to reduce overall test-ordering behaviour. In the United States, Epstein and colleagues3 found that those physicians who scored low on measures of patient-centredness when compared with those who scored higher had greater diagnostic testing expenditures. Even after controlling for the shorter-visit-length characteristic of low-scoring physicians, this difference remained. Total expenditures, including testing and ambulatory and hospital care, were also higher in those who scored low on this measure.

In an analysis of the Patient-Centred Outcomes Study, Stewart and colleagues4 found that mean diagnostic costs in the 2 months following an index visit were significantly higher (P < .004) for physicians who scored in the lowest quartile in measures of patient-centredness compared with physicians scoring in the highest quartile ($29.48 vs $11.46). When these figures were extrapolated, the extra costs per month amounted to $14 million provincially and $38 million nationally. Clearly patient-centred care provides substantial cost savings, as well as better care and greater patient and physician satisfaction.

Identifying unnecessary test ordering is an important first step but needs to be translated into action at the practice level. Taking a patient-centred approach has been demonstrated to show the way.

Footnotes

  • Competing interests

    None declared

  • Copyright© the College of Family Physicians of Canada

References

  1. 1.↵
    1. Hudzik B,
    2. Hudzik M,
    3. Polonski L
    . Choosing wisely. Avoiding too much medicine. Can Fam Physician 2014;60:873-6. (Eng), 884–7 (Fr).
    OpenUrlFREE Full Text
  2. 2.↵
    1. Stewart M,
    2. Brown JB,
    3. Weston WW,
    4. McWhinney IR,
    5. McWilliam CL,
    6. Freeman TR
    . Patient-centered medicine. Transforming the clinical method. 3rd ed. New York, NY: Radcliffe Publishing; 2014.
  3. 3.↵
    1. Epstein RM,
    2. Franks P,
    3. Shields CG,
    4. Meldrum MS,
    5. Miller KN,
    6. Campbell TL,
    7. et al
    . Patient-centered communication and diagnostic testing. Ann Fam Med 2005;3(5):415-21.
    OpenUrlAbstract/FREE Full Text
  4. 4.↵
    1. Stewart M,
    2. Ryan BL,
    3. Bodea C
    . Is patient-centred care associated with lower diagnostic costs? Healthc Policy 2011;6(4):27-31.
    OpenUrlPubMed
PreviousNext
Back to top

In this issue

Canadian Family Physician: 60 (12)
Canadian Family Physician
Vol. 60, Issue 12
1 Dec 2014
  • Table of Contents
  • About the Cover
  • Index by author
Print
Download PDF
Article Alerts
Sign In to Email Alerts with your Email Address
Email Article

Thank you for your interest in spreading the word on The College of Family Physicians of Canada.

NOTE: We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. We do not capture any email address.

Enter multiple addresses on separate lines or separate them with commas.
Patient-centred approach is the way
(Your Name) has sent you a message from The College of Family Physicians of Canada
(Your Name) thought you would like to see the The College of Family Physicians of Canada web site.
CAPTCHA
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
Citation Tools
Patient-centred approach is the way
Tom R. Freeman
Canadian Family Physician Dec 2014, 60 (12) 1081;

Citation Manager Formats

  • BibTeX
  • Bookends
  • EasyBib
  • EndNote (tagged)
  • EndNote 8 (xml)
  • Medlars
  • Mendeley
  • Papers
  • RefWorks Tagged
  • Ref Manager
  • RIS
  • Zotero
Respond to this article
Share
Patient-centred approach is the way
Tom R. Freeman
Canadian Family Physician Dec 2014, 60 (12) 1081;
del.icio.us logo Digg logo Reddit logo Twitter logo CiteULike logo Facebook logo Google logo Mendeley logo
  • Tweet Widget
  • Facebook Like
  • Google Plus One

Jump to section

  • Article
    • Footnotes
    • References
  • Info & Metrics
  • eLetters
  • PDF

Related Articles

  • No related articles found.
  • PubMed
  • Google Scholar

Cited By...

  • No citing articles found.
  • Google Scholar

More in this TOC Section

  • Water for weight loss
  • Head-to-head IUS comparison needed
  • Clarifying MAID eligibility
Show more Correspondance

Similar Articles

Navigate

  • Home
  • Current Issue
  • Archive
  • Collections - English
  • Collections - Française

For Authors

  • Authors and Reviewers
  • Submit a Manuscript
  • Permissions
  • Terms of Use

General Information

  • About CFP
  • About the CFPC
  • Advertisers
  • Careers & Locums
  • Editorial Advisory Board
  • Subscribers

Journal Services

  • Email Alerts
  • Twitter
  • RSS Feeds

Copyright © 2023 by The College of Family Physicians of Canada

Powered by HighWire