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Steven C. Bergeson, MD; John D. Dean, MBChB, MD, FRCP

JAMA. 2006;296:2848-2851.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

Providing care centered on patients' needs and expectations is a key attribute of quality care.¹ Unfortunately, despite the intent and efforts of many to improve patient centeredness, the quality of patient-clinician relationships, patient access, and continuity of care appear to be worsening in the United States² and lag behind other Organization for Economic Co-operation and Development (OECD) countries.³ Clinicians do not consistently address patients' concerns,⁴ do not always assess patients' beliefs and understanding of their illness, and often do not share management options with patients.⁵ Patients frequently fail to recall basic elements of their care plan.⁶ All this is occurring as care becomes increasingly complex and as more costs of care are borne directly by patients.

In this Commentary, we propose 4 specific changes that should help the medical profession meet patients' needs and expectations. These changes involve redesigning the . . . [Full Text of this Article]

Redesigning Systems

Author Affiliations: Institute for Healthcare Improvement, Cambridge, Mass (Drs Bergeson and Dean); Allina Hospitals and Clinics, Shoreview, Minn (Dr Bergeson); and Bolton Primary Care Trust, Bolton, England (Dr Dean).

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