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Am J Kidney Dis. 2018 Feb 9. pii: S0272-6386(18)30001-5. doi: 10.1053/j.ajkd.2017.11.022. [Epub ahead of print]

Patient-Centered Care in Renal Medicine: Five Strategies to Meet the Challenge.

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Division of Nephrology, Kidney Research Institute, and Department of Health Services, University of Washington; and Veterans Affairs Puget Sound Health Care System, Seattle, WA. Electronic address:


There is growing interest in patient-centered care, defined by the Institute of Medicine as "care that is respectful of and responsive to individual patient preferences, needs, and values." Although generally accepted as uncontroversial, the notion of "centering" care on our patients is in fact quite revolutionary. Because medical teaching, research, and practice have traditionally been organized around diseases and organ systems rather than patients, making care more patient centered would require no less than a paradigm shift in how we practice medicine. This would call for a frameshift in how we envision our role as health care providers and fundamental changes to the health care delivery systems in which we practice. Although individual providers may have limited power to change health systems (at least in the short term), there are some simple strategies within our reach that can help make our care more patient centered. These include a willingness to listen, make time, go beyond our job description, re-imagine what it means to provide "good" care, and see value in relationship building. Although putting these practices to work in the complex, specialized, and fragmented health systems in which many of us operate may be challenging, I would argue that this is a "beautiful challenge" with potentially far-reaching benefits for both patients and providers.


Patient-centered care; health care system; medical education; nephrology; practice of medicine; renal medicine; shared decision making

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