Patients’ needs addressed in ‘person-centered health care’

Every time JoAnna James took her husband, Lawrence, to the doctor, she left the hospital without understanding what was wrong with him.

“You ask (doctors) to break it down so you can understand what they are saying and they make you feel like there is something wrong with you,” said James, 67.

Frustrated, the couple signed up two years ago for an experimental program at the University of Chicago Medicine. The James’ new primary care doctor explained Lawrence’s prostate cancer diagnosis and every procedure that followed until they understood each of them. “She speaks your language,” JoAnna James said.

The Comprehensive Care Program, funded with a $6.1 million federal grant, is an example of a new model of care aimed at changing the culture of America’s health care system to one where doctors treat people rather than symptoms.

For example, when Lawrence James became too sick to leave the house, the program sent a doctor to the couple’s home. After he died in the spring, the couple’s doctor alerted specialists treating JoAnna James, in case her health deteriorated.

The individualized model of care, called “person-centered care” or “patient-centered care,” is based on the concept that costs can be reined in by preventing expensive emergency room visits. It is beginning to take hold among those caring for the sickest and oldest patients. But by far, the fee-for-service model, where doctors are paid for the services they provide regardless of the outcome, is still the main system in the United States.

“It’s hard to change what’s been embedded in concrete for decades,” said Robert Berenson, a fellow at the Urban Institute and co-author of “The Road to Making Patient-Centered Care Real: Policy Vehicles and Potholes.” He added, “There is a lot of resistance from major stakeholders that do well in the status quo.”

One hurdle to overcome is getting people to buy into the concept. Its wonky name makes people think it’s just a gimmick to cut services, experts say.

A poll of Americans age 40 and over conducted this year by The Associated Press-NORC Center for Public Affairs Research revealed some skepticism among those who have not tried this new kind of care. More than half of people receiving or providing care without a single health care manager, an aspect of person-centered care, didn’t think their care would improve much if they had one, while more than three quarters of those who had one said it improved things a lot.