The concept of person-centered care, defined by the WHO as healthcare that respects individual needs and values, has been a cornerstone of quality improvement since the early 2000s. This approach emphasizes patient autonomy in choosing goals, treatments, and delivery methods.
Despite widespread agreement in principle, a significant gap often exists between person-centered ideals and actual clinical practice. Research into goal-setting and pain management reveals that clinicians may default to familiar approaches, system-driven rewards, or assumptions about why patients seek care, rather than prioritizing individual preferences. Patients, particularly those with pain, seek help not just for symptom intensity but for impacts on daily life, social participation, mood, and overall quality of life.
A potential reason for this disconnect is the enduring dominance of the biomedical model, which focuses on physical causes and treatments. This reductionist view can overlook the complex, holistic nature of human experience, treating the mind and body separately and patients as passive recipients of care.
Navigating this dilemma requires clinicians to actively identify a patient's primary concern beyond pain intensity, understand its meaning to the individual, and present evidence-based options. Success should be defined from the patient's perspective, considering both short-term and long-term implications. Empowering patients with decision-making authority, even if it means facilitating options outside the clinician's direct offering, fosters autonomy and can be a powerful intervention in itself.