- learn about the conceptual framework Hodges' model. A tool that can help integrate HEALTH and SOCIAL CARE, INFORMATICS and EDUCATION. The model is situated, facilitates person-centredness, integrated - holistic care and reflective practice. A new site using Drupal is an ongoing aim - the creation of a reflective workbench. Email: h2cmng @ yahoo.co.uk Welcome

Tuesday, October 28, 2014

Patient-Practitioner disconnect c/o Healthcare Innovation by Design

https://www.linkedin.com/groups?home=&gid=2579818&trk=anet_ug_hmA post on a LinkedIn group I follow Healthcare Innovation by Design roused my interest -

What's the Source of the Patient-Practitioner Disconnect? 

Invariably on the web one item relates to another and so with this:

Doctors Tell All—and It’s Bad (The Atlantic)
A crop of books by disillusioned physicians reveals a corrosive doctor-patient relationship at the heart of our health-care crisis.

Just the above mention of corrosive suggests a great deal about the pressures on relationships in health and social care. Is there a mechanistic failure to follow? It sounds like metal fatigue, if not in the actual relationships then the financial systems that underpin them?

Stephanie Frederick's post also invited the views of other healthcare professions, recognising this is not limited to medics. My own experience would identify the disconnect as resulting from a preoccupation with assessment.

As community mental health nurses this is what we do. Risk assessment is the critical focus. Collectively we assess, problem solve, evaluate and draw upon the resources of the community team and many other agencies then discharge the patient back to the GP general practitioner. There is little or, no time for therapeutic intervention.

You could say empathy and rapport have been reduced to gestures. This would be fine if it's technology we are gesticulating to: but it isn't.

It's a unique individual, a person trying to manage a new or recurrent problem. With them may be family members also struggling to make sense of a disruptive situation that may also be life-changing. If they have no family what then?

It isn't that I'm missing the custard creams with the coffee, it's the frustration of reading about the need for new models of care. Of course, many of these calls are for new financial, commissioning and organisational models; but other models are essential to negotiate the shift to self-care. And yes, I would advocate for Hodges' model as a candidate here.

Who is going to do this? 
Do what? 

Well, restore person-centered care to what it should be: more than a policy gesture.

We need to finally address the health services - health promotion AND the educational issue contained in each.

That's one source of disconnect... or ok several...

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