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PCCM (One Pager)

- William Osler


Hudon 2011)

Illness,health, context
(Little 2001)

(Stewart 2014)
Tadao Okada, MD, MPH @ Primary Care Institute Japan

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last updated on 2014/06/25

Rao et al (2007):

Dwamena et al (2012):
fairly strong evidence

Zolnierek, DiMatteo(2009):

Dwamena et al (2012):

Jani et al (2012): PHQ-9

Epstein (2005):
Stewart (2011): $ 29.48 vs $ 11.46
Stewart 1989
8.5 10.57.8
10.9-12.0Epstein (200518.8
vs 22.8

Shared Decision Making(SDM)



Tadao Okada, MD, MPH @ Primary Care Institute Japan

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Disease: biomedical




Stewart , Brown , Weston. Patient-Centered Medicine: Transforming the Clinical Method (3rd ed.). Radclie Medical Press (2014-04-30)
Hudon et al. Measuring Patients Perceptions ofPatient-Centered Care: A Systematic Review of Tools for Family Medicine. Ann Fam
Med 2011;9:155-164.
Little P, Everitt H, Williamson I, et al. Preferences of patients for patient centred approach to consultation in primary care: observational
study. BMJ. 2001;322(February):908-911.
Rao J K, Anderson L A, Inui T S, Frankel R M. Communication interventions make a dierence in conversations between physicians and
patients: a systematic review of the evidence. Med Care. 2007; 45(4): 340-9
Dwamena F, et al. Interventions for providers to promote a patient-centred approach in clinical consultations. Cochrane Database of
Systematic Reviews 2012, Issue 12. Art. No.: CD003267
Zolnierek, DiMatteo. Physician Communication and Patient Adherence to Treatment: A Meta-analysis. Med Care. 2009 August ; 47(8):
Jani et al. Patient centredness and the outcome of primary care consultations with patients with depression in areas of high and low
socioeconomic deprivation. Br J Gen Pract. Aug 2012; 62(601): e576e581
Epstein et al. Patient-Centered Communication and Diagnostic Testing. Ann Fam Med 2005;3:415-421.
Stewart et al. Is Patient-Centred Care Associated with Lower Diagnostic Costs? Healthcare Policy 2011; 6(4): 27-31
Moira Stewart, Judith Belle Brown, and W. Wayne Weston. Patient-Centred Interviewing Part III: Five Provocative Questions. Can Fam
Physician. Jan 1989; 35: 159161.

Tadao Okada, MD, MPH @ Primary Care Institute Japan

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Incorporating Prevention and

Health Promotion

(heath promotion)
health and
strength, strength and resilience
health promotion resilience
Cassell2013 (: the nature of healing

heath education and disease prevention)

Being Realistic
The Health Care Context and Patient-Centered Care

Stewart the patient s perception of health, what health means to them, their
ability to pursue the aspiration, purposes important to their lives
disease illnesshealthdisease
voice of medicine, voice of lifeworld, (Mishler 1984) lifeworld ignored, lifeworld blocked,
mutual lifeworld, strictly medicine (Barry 2001)

health promotion
heath promotionprevention
self ecacy

well-being(WHO 1940)WHO 1986

Eric J. Cassell. The Nature of Healing: The Modern Practice of Medicine. New York, Oxford University Press, 2013
Mishler EG. Discourse of Medicine: Dialectics of Medical Interviews. Norwood, NJ: Ablex; 1984
Barry CA et al. Giving voice to the lifeworld. More humane, more eective medical care? A qualitative study of doctor-patient
communication in general practice. Soc Sci Med. 2001 Aug;53(4):487-505.

Tadao Okada, MD, MPH @ Primary Care Institute Japan

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