Friday, October 5, 2012

Re-Introducing Human Centering in the Health Home

Two years ago I was learning about Human Centering from Steve Deal, Human Systems Engineer among other talents.  I am reposting one of the blog posts about human centering which is the center of the Human Centered Health Home (HCHH). I get to do this every day and it's fun.  There is fun in Family Medicine!

Wednesday, November 30, 2011

Human Centering: Mutual Respect Opportunity in Health Care

Human Centering (NHBPM Day 29)

(Published first by me in Wego Health NHBPM Challenge 11/30/2011.  Click link above for original post.)

As the stress mounts in the health care (non) system, involved persons such as patients and physicians will need enhanced communication skills to effectively communicate with each other.  Physicians are getting more distracted by technology and reporting mandates (also known as quality initiatives) while patients are getting more distracted by their fading finances and increasingly convoluted rules of third party payers such as insurance companies, employers and the government (tax payers).
In the Family Medicine office setting, how is this enhanced skill possible?

One strategy is called human centering.  Since family medicine is relationship based instead of disease or part based health care, the human connection between patient and doctor is worthy of extra consideration. How does this dyad establish and maintain the patient-physician relationship?  One way is by focusing on the human aspects of each other first.

What values of the patient and the physician overlap?  How might they reveal their humanity before shifting to the role of patient and doctor?

First, it helps to realize that each member of the dyad shifts through a few different roles before, during and after the office encounter.  These roles might include human, learner, teacher, friend, patient, physician, consumer, consumer coach,  and others depending on the context and flow of the interaction.
A simple greeting including eye contact, positive facial expression, verbal greeting which includes the name of the other person, and sometimes a handshake provide an opportunity for human sharing before therapeutic connection is established.  Assuming an attitude of respect and curiosity about the other person affords an opportunity to better share information.  "When did you start the beard, Dr. Jonas?" is specific enough to take Dr. Jonas out of his physicianly, trance-like state.  Using the person's name is a not-so secret approach to shifting the dyad out of focus to redirect it toward another subject.

Expressing appreciation for something done by the other or teaching the other person something are useful ways to seek human centering for the dyad.  As they learn from and about each other, they can build respect and appreciation for their individual and shared uniqueness.  As they expand their understanding of each other, their shared humanity becomes an anchor upon which to allow probing questions of each other, including expressions of doubt and fear.  This anchoring may give extra protection of the dyad from less desirable (money sucking or risky) encounters with the less useful aspects (such as unnecessary radiation exposure or avoidable expense) of the Medical Industrial Complex.

The humanness of the individuals in the dyad delivers the base on which enhanced health and patient safety allow better mutual exploration of subsequent confusing clinical information.  The initial human centering allows the dyad to become a decision making unit of considerable quality.  As patients and physician allow their humanity to mutually connect, human centering initiates a higher quality clinical interaction, decreasing the potential for harmful, costly or dangerous clinical decisions.

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