Defining “Patient-Centered Medicine”

What is the proper relation between a scientific understanding of disease and the subjective phenomenon of being sick? Between the subspecialist and the general physician? Between cure and care? “Patient-centered medicine” is the newest salvo in these debates. A patient consults an orthopedist because of knee pain. The surgeon determines that no operation is indicated and refers her to a rheumatologist, who finds no systemic inflammatory disease and refers her to a physiatrist, who sends her to a physical therapist, who administers the actual treatment. Each clinician has executed his or her craft with impeccable authority and skill, but the patient has become a shuttlecock. Probably a hassled, frustrated, and maybe bankrupt shuttlecock. The themes are very old. The Hippocratic Oath itself enjoins physicians to maintain their deportment and privileges while keeping the patient's interests foremost. What is the . . .