Transcript Herbs or Hormones? (Options in Menopause)

Person-Centered Care
THE Organizing Principle
for Healthcare
Milt Hammerly, MD
IOM Principles - STEEEP
•
•
•
•
•
•
Safe
Timely
Effective
Efficient
Equitable
Patient-Centered
patient
n.
1. One who, or that which, is passively affected; a passive recipient.
Malice is a passion so impetuous and precipitate that often involves the
agent and the patient. --Gov. of Tongue.
2. A person under medical or surgical treatment; -- correlative to physician
or nurse.
Like a physician, . . . seeing his patient in a pestilent fever. --Sir P. Sidney.
In patient, a patient who receives lodging and food, as treatment, in a
hospital or an infirmary.
Out patient, one who receives advice and medicine, or treatment, from an
infirmary.
Source: Webster's Revised Unabridged Dictionary, © 1996, 1998 MICRA,
Inc.
patient
adjective
Synonyms: accommodating, calm, composed, easy-going, enduring, eventempered, forbearing, forgiving, gentle, imperturbable, indulgent, lenient,
long-suffering, meek, mild, mild-tempered, persevering, persistent,
philosophic, philosophical, quiet, resigned, self-possessed, serene, stoical,
submissive, tolerant, tranquil, uncomplaining, understanding, unruffled,
untiring
noun
Synonyms: case, convalescent, emergency, inmate, invalid, outpatient,
shut-in, sick person, subject, sufferer, victim
Source: Roget's New Millennium™ Thesaurus, First Edition (v 1.0.5)
Copyright © 2004 by Lexico Publishing Group, LLC. All rights reserved.
per·son
n.
A living human.
The composite of characteristics that make up an individual personality; the self.
The living body of a human.
Physique and general appearance.
Source: The American Heritage® Stedman's Medical Dictionary
Copyright © 2002, 2001, 1995 by Houghton Mifflin Company. Published by
Houghton Mifflin Company.
Person
Noun
Synonyms: being, bird, body, cat, chap, character, dude, fellow, guy, human,
identity, individual, individuality, joker, lad, life, living soul, man, mortal, party,
personage, personality, self, somebody, soul, specimen, spirit
Source: Roget's New Millennium™ Thesaurus, First Edition (v 1.0.5)
Copyright © 2004 by Lexico Publishing Group, LLC. All rights reserved.
Safety
Integrative
(Person-Centered)
Healthcare
Science
Comprehensive
in scope
Collaborative
Personalized
of necessity
by design
Patient triage
(risk-stratification)
Integrative
(Person-Centered)
Healthcare
Contextually
ranked evidence
Surgery
More
Aggressive
More
Risky
More
Costly
More
Passive
CAM
Biochemical
CAM
Structural
Less
Aggressive
Less
Risky
Less
Costly
Less
Passive
Biochemical
Structural
Movement
Environment
Mind-Body
Energy
Pharmacy
Unifying Taxonomy (based on presumed mechanisms of action)
Potential Mechanisms of Interactions
(good or bad)
Pharmacokinetic (A.U.C.)
• E Absorption
– Binding
– Permeability
• Brush border transport
• Circulation
– Precipitation
– Transit time
•
E Metabolism-½ life
– Liver P-450 system
– Renal
– Other tissues
• Metabolite modulation
Pharmacodynamic
• Receptor site competition
• Additive therapeutic effect
– Same mechanism/active ingredient
– Other mechanism/active ingredient
• Reduced therapeutic effect
– Opposite mechanism
– Other mechanism
• Additive toxicity
– Same mechanism/active ingredient
– Other mechanism/active ingredient
• Reduced toxicity
– Repletion/depletion
– Altered physiology/other
When did it become
illicit to elicit …
… the mind-body
response?
“A mind is a terrible thing to waste.”
(UNCF)
Healthcare
(per Dr. Herbert Benson)
What the stool supports ...
Healthcare
Disintermediate
whenever possible
If needed
What supports the stool?
Empower however
possible
… a person!
What the stool supports ...
Healthcare
Collaborative Coalition
Solid
Ground
What supports the stool?
(stakeholders to include:
employers, insurers,
policymakers, providers,
NGOs, manufacturers,
vendors, etc.)
Person
(Products can include
foods, programs, info,
decision support tools,
etc.)
Payers
Products
Providers
Purchasers
Person
Payers
Products
Providers
Actualization is the
capstone
Purchasers
Person-centered care strives to meet all of a person’s needs.
Spirit
Mind
Body
Maslow’s Hierarchy