Introduction to Person-Centred Medicine: from Concepts
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Journal of Evaluation in Clinical Practice ISSN 1365-2753 From the Second Geneva Conference on Person Centered Medicine Person-Centered Medicine: From Concepts to Practice EDITORIAL Introduction to person-centred medicine: from concepts to practicejep_1606 330..332 Juan E. Mezzich MD PhD,1 Jon Snaedal MD,2 Chris van Weel MD PhD,3 Michel Botbol MD4 and Ihsan Salloum MD MPH5 1President, International Network for Person-centered Medicine, President 2005–2008, World Psychiatric Association and Professor of Psychiatry, Mount Sinai School of Medicine, New York University, New York, USA 2President 2007–2008, World Medical Association and Board Member, International Network for Person-centered Medicine, Department of Geriatrics, Landspitali University Hospital, Reykjavik, Iceland 3President 2007–2010, World Organization of Family Doctors, Board Member, International Network for Person-centered Medicine and Professor of General Practice, Radboud University, Nijmegen, The Netherlands 4Board Member, International Network for Person-centered Medicine and Associate Professor, School of Psychology, Catholic University, Paris, France 5Board Member, International Network for Person-centered Medicine and Professor of Psychiatry, University of Miami, Miami, Florida, USA Keywords Correspondence person-centred medicine, science and Professor Juan E. Mezzich Accepted for publication: 11 October 2010 humanism in medicine Mount Sinai School of Medicine New York University doi:10.1111/j.1365-2753.2010.01606.x Fifth Ave and 100th St, Box 1093 New York, NY 10029 USA E-mail: [email protected] The early roots of the concept of person-centred medicine can be the International Council of Nurses (ICN), the European Federa- found in the comprehensive notion of health and the personalized tion of Associations of Families of People with Mental Illness approaches to medical care discernible in both Eastern and (EUFAMI), the International Alliance of Patients’ Organizations Western ancient civilizations [1,2]. Other significant precedents (IAPO) and the Paul Tournier Association. include contemporary developments in clinical medicine and The Conference had as principal purposes to examine and public health challenging an overemphasis on specific organs and discuss key concepts of person-centred medicine and practical disease and seeking to place the whole person at the centre of approaches for its implementation, to elicit useful initiatives on medicine [3]. person-centred medicine and to engage international medical and The recent coordinated global effort towards person-centred health organizations on the Conference’s theme. medicine started with an inaugural Geneva Conference on Person- The Conference Organizing Committee was composed of J.E. centred Medicine in May 2008. It involved the collaboration of Mezzich (World Psychiatric Association President 2005–2008), J. major international medical and health organizations and a group Snaedal (World Medical Association President 2007–2008), C. of committed clinicians and scholars [4]. van Weel (World Organization of Family Doctors President 2007– The Second Geneva Conference took place on 28 and 29 May 2010) and I. Heath (World Organization of Family Doctors Execu- 2009 under the auspices of the University of Geneva Medical tive Committee Member at Large). The Conference Secretariat School and the University Hospitals of Geneva organized by the was based at the International Center for Mental Health, Mount World Medical Association (WMA), the World Organization of Sinai School of Medicine, New York University. Family Doctors (Wonca) and the International Network for Financial and in-kind support for the Conference was provided Person-centered Medicine (INPCM), in collaboration with the by the University of Geneva, the Paul Tournier Association of Council for International Organizations of Medical Sciences Geneva, Person-centered Medicine & Psychiatry Programs, Con- (CIOMS), the World Federation for Mental Health (WFMH), the ference registration fees and the emerging International Network World Federation of Neurology (WFN), the World Association for for Person-centered Medicine [5]. Sexual Health (WAS), the International Association of Medical The Conference was opened by the Rector of the University Colleges (IAOMC), the World Federation for Medical Education of Geneva and the Vice-Dean of its Medical School, as well as (WFME), the International Federation of Social Workers (IFSW), by the members of the Conference Organizing Committee. All 330 © 2010 Blackwell Publishing Ltd, Journal of Evaluation in Clinical Practice 17 (2011) 330–332 J.E. Mezzich et al. Editorial remarked on the tradition that was being established engaging opment of pertinent guidelines and curricula for person-centred Geneva as encounter point for the development of person-centred clinical care, the assessment of an epistemologically based person- medicine. centred medicine at Ambrosiana University in Milan, training and The first scientific session involved presentations of leaders and research on communication for person-centred outcomes, and representatives of the International Alliance of Patients’ Organi- broad programmatic features and objectives of research on person- zations, the International Network for Person-centered Medicine, centred clinical care. the World Health Organization, the World Medical Association, The ninth conference session reviewed person-centred health the World Organization of Family Doctors, the Council of Inter- systems and policies. WHO’s new focus on persons for the devel- national Organizations of Medical Sciences and the International opment of more promising global health policies and systems, as Council of Nurses. The presentation of policy statements and affirmed by the latest World Health Assembly, was given pointed relevant institutional programmes reflected the value ascribed by attention. Also discussed was the role of health informatics for the these organizations to person-centred medicine. The abstracts of construction of personalized medicine and complex health care the presentations made at this and the following sessions of the systems. Last but not least was a review of the role and docu- Second Geneva Conference have been posted at the INPCM mented value of the person for the conduction of health care, website, http://www.personcenteredmedicine.org. training and research Eight special initiatives relevant to person-centred care were The final tenth session presented a conference summary and presented in the second session. The presentations were made by outlined next steps. Among the general conclusions were (1) a representatives of several major organizations collaborating in commitment to the importance of person-centred medicine for the Second Geneva Conference and other prominent work groups. the health of people, noting the participation of a vast array of The diverse experiences presented from a range of fields revealed important medical and health organizations, a wish to share substantive achievements and promising opportunities for a medi- and collaborate and an understanding of the importance of grasp- cine of the person. ing opportunities in the field; (2) the growing availability of Concepts and meanings of person-centred medicine were the resources, including general concepts and procedures as well subject of the third session. They focused on the role and worth of as teaching materials and research tools; and (3) the importance the person in medicine, the cruciality of sense of identity, empathy of fitting the above resources into health care systems and into and engagement for optimal clinical care, and the value and impact particular health care encounters, with especial attention to of life experiences for the development in each individual of per- person-centredness as an intrinsic quality rather than as an addi- sonalized medicine and health. tional commodity, and the value of comprehensiveness, continu- The fourth session presented and discussed procedures for ity, and attention to context as crucial features of good clinical person-centred diagnosis. Particularly covered were the signifi- care. cance of multilevel explanations and diagnosis in medicine, the Anticipated next steps included the following: (1) completion of key features of a person-centred integrative diagnosis addressed a joint editorial to be published in an international journal; (2) to appraise whole health using standardized and narrative preparation of a Second Geneva Conference Summary Report, (3) descriptions reflecting interactions among clinicians, patient and publication of a set of selected papers presented at the Second family, as well as the prospects for person-centred diagnosis in Geneva Conference; (4) collaboration with WHO on Person- general medicine. centred Medicine topics related to the 2009 World Health Assem- A panel on programmatic contributions for person- bly Resolutions; (5) organization of scientific events relevant to centred medicine in a fifth session offered an opportunity for person-centred medicine, such as a prospective New York Confer- the presentation of brief statements by representatives of ence on Well-Being and Person in Medicine and Health; (6) plan- 12 collaborating organizations and groups from across the world. ning a clearinghouse of Person-centred Medicine documents; (7) They attested to the relevance of person-centred approaches upgrading an internet platform to support archival, informational, to medicine for an ample range of medical, health and social communicational