Assessing Patient-Centred Care Through Direct Observation of Clinical Encounters

Ironically the most private and sensitive part of medical care is also one of the most accessible to measurement – yes doctor-patient psychological interaction (communication is too shallow a word) can be observed directly and does not suffer from poor signal to noise ratios since it differs so much between doctors and across contexts. It can be calibrated on a continuous or ordinal scale, and thus tends to be measured with high precision. The CLAHRC WM Director does not know how reliable it is, but it is undoubtedly hugely important. Stojan and colleagues [1] write a very nice paper about this subject and remind us of the chilling finding that doctors tend to adopt a different style for different ethnic groups. It is important that we have this mirror in place. There is no asymptote to improved interaction with patients, and we should feel good about ourselves because we have faced up to our imperfections and are trying to improve, rather than bad because we are not perfect in this – by far the most difficult – aspect of professional practice.

— Richard Lilford, CLAHRC WM Director


  1. Stojan JN, Clay MA, Lypson ML. Assessing patient-centred care through direct observation of clinical encounters. BMJ Qual Saf. 2016; 25: 135-7.

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