Understanding Healing Relationships in Primary Care
John G. Scott,Deborah J. Cohen,Barbara DiCicco-Bloom,William L. Miller,Kurt C. Stange,Benjamin F. Crabtree,Benjamin F. Crabtree +6 more
TLDR
This conceptual model of clinician-patient healing relationships may be generalizable to other kinds of healing relationships and have an underlying structure and lead to important patient-centered outcomes.Abstract:
PURPOSE Clinicians often have an intuitive understanding of how their relationships with patients foster healing. Yet we know little empirically about the experience of healing and how it occurs between clinicians and patients. Our purpose was to create a model that identifies how healing relationships are developed and maintained.
METHODS Primary care clinicians were purposefully selected as exemplar healers. Patients were selected by these clinicians as having experienced healing relationships. In-depth interviews, designed to elicit stories of healing relationships, were conducted with patients and clinicians separately. A multidisciplinary team analyzed the interviews using an iterative process, leading to the development of case studies for each clinician-patient dyad. A comparative analysis across dyads was conducted to identify common components of healing relationships
RESULTS Three key processes emerged as fostering healing relationships: (1) valuing/creating a nonjudgmental emotional bond; (2) appreciating power/consciously managing clinician power in ways that would most benefit the patient; and (3) abiding/displaying a commitment to caring for patients over time. Three relational outcomes result from these processes: trust, hope, and a sense of being known. Clinician competencies that facilitate these processes are self-confidence, emotional self-management, mindfulness, and knowledge.
CONCLUSIONS Healing relationships have an underlying structure and lead to important patient-centered outcomes. This conceptual model of clinician-patient healing relationships may be generalizable to other kinds of healing relationships.read more
Citations
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Defining and measuring the patient-centered medical home
Kurt C. Stange,Paul A. Nutting,William L. Miller,Carlos Roberto Jaén,Benjamin F. Crabtree,Susan A. Flocke,James M. Gill +6 more
TL;DR: Efforts to transform practice to patient-centered medical homes must recognize, assess and value the fundamental features of primary care that provide personalized, equitable health care and foster individual and population health.
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The Problem of Fragmentation and the Need for Integrative Solutions
TL;DR: In the United States and around the world, the low value of the US healthcare system and analogous difficulties in other countries have elicited calls for bold action to address these problems.
Journal ArticleDOI
Primary Care Practice Development: A Relationship-Centered Approach
TL;DR: A relationship-centered practice development approach to understand practice and to aid in fostering practice development to advance key attributes of primary care that include access to first-contact care, comprehensive care, coordination of care, and a personal relationship over time is presented.
Journal ArticleDOI
Healing skills for medical practice.
Larry R. Churchill,David Schenck +1 more
TL;DR: Eight Practitioner Skills That Promote Healing Relationships Small courtesies and congenial manners, such as smiling, shaking hands, acknowledging others in the room, and making eye contact, often turn out to be highly significant, especially at the beginning of a relationship.
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