Changes in the economics and delivery of dentistry have resulted in suggestions for significant changes in the delivery of care. These guidelines emphasize increased patient involvement in the treatment of chronic diseases such as dental caries and periodontitis. This approach, which is termed patient-centered care (PCC), also emphasizes the direct participation of the patient in formulating treatment plans. This approach requires understanding the patient's goals and involving them in therapeutic decisions, as well as an emphasis on long-term behavioral changes needed to control these diseases, and monitoring therapeutic outcomes in a formal way. This approach is currently applied in very few private practices and is poorly understood by the average practitioner. In the past, similar approaches have yielded equivocal results. If these concepts are routinely practiced they will increase the economic burden on private practices and increase the use of third-party involvement for these services.
Patient-centered care (PCC) is receiving increased attention (Porter 2010). This approach has been defined as “provision of care that is respectful of and responsive to individual patient preferences, needs and values, and ensuring that patient values guide all clinical decisions” (Richardson et al. 2001). Stated goals include improving clinical outcomes and reducing costs. Instituting this approach involves identifying the behavioral changes necessary for controlling chronic diseases. It also includes tracking of patient outcomes.
Patient-centered care has been said to contain the following common modalities:
- It explores the patient's main reason for the visit, concerns and need for information
- It seeks an integrated understanding of the patient’s world-that is, their whole person, emotional needs, and life issues
- It finds common ground on what the problem is and mutually agreed-on management of that problem
- It is intended to enhance prevention and health promotion file and the continued relationship between the patient and the doctor (Stewart 2001)
PCC is designed to replace more traditional approaches to care. It blends the patient's needs and preferences with the clinical expertise of the therapist, who is encouraged to use available scientific evidence in formulating treatment plans. With PCC, patient preferences take precedence in therapeutic options over that of the clinician in formulating treatment plans. This means that therapy deemed optimal by the dental professional is modified by patient preference.
It has been suggested that using PCC can help reduce the deleterious effects of chronic preventable diseases such as dental caries and periodontal disease while improving patient outcomes. The purpose of this paper is to explore available data on the subject and discuss the application of PCC to private dental practice.