The Cleveland Clinic intentionally puts a focus on relationship-centered care.
“When there’s an emphasis on patient-centered care, some physicians have a hard time figuring out what to do when the patient wants something that the physician doesn’t feel is appropriate,” said Katie Neuendorf, MD, director for the Center for Excellence in Healthcare Communication. “Patient-centered implies that the patient is always right and that their opinion should win out over the physician’s opinion. In that same scenario, relationship-centered care implies that the relationship should be prioritized, even when there’s disagreement in the plan of care. I can tell my patients that I hear what they are saying, that I empathize with their struggles, that I care about the way the illness is affecting their lives, and that I am here to support them. I can do all of that and still not prescribe a treatment that I feel is inappropriate just because it happens to be what the patient wants.”
Dr. Kathleen Neuendorf
The development of a relationship between the patient and the physician has benefits for the physician, such as decreased rates of burnout, as well as better health outcomes for the patient, according to the results of several studies.3,5 Given these benefits, in 2014, two physicians advocated for a Quadruple Aim to replace the standard Triple Aim.6 “The Quadruple Aim recognizes that improving health care providers’ work life is imperative in keeping health care functioning,” Dr. Neuendorf said.
The Cleveland Clinic’s Relationship Establishment, Development and Engagement (REDE) course helps clinicians to see the individual that exists beyond a diagnosis. “Having empathy, or putting yourself in the other person’s shoes, is a key step in that process,” Dr. Neuendorf said. “Once a physician understands the patient’s perspective, the treatment for the diagnosis is more meaningful to both the patient and physician. Finding meaning in their work addresses the Quadruple Aim.”