From a patient’s perspective: determining treatment according to preferences and personal values


In Egypt, there is no doubt that advances in medicine have given us plenty of options to improve general health outcomes, however, the gap between physicians and patients remains noticeably wide. Individuals receiving treatment, as well as their families, are excluded from making decisions relevant to the clinical management of their health problems, and the possibility of choosing the “personally most suitable” or preferred option, from a wide array of treatments, becomes inhibited.

Worldwide, it has been established that placing patients at the center of healthcare is an effective way to overcome distance between healthcare professionals and patients. The term “patient-centered care” was first utilized by the Picker/Commonwealth Program for Patient-Centered Care, in a multiyear national project that comprised focus interviews and phone surveys with patients and families with the aim of understanding the patient’s experience.

In addition to the aforementioned program, the Institute for Family‐ Centered Care and the Planetree model also identified a number of essential quality and safety indicators from a patient’s perspective. These programs became some of the most influential examples that steered patient-centered care in the United States, and all of which aspire to secure patients’ physical and emotional comfort and well-being. This does not only result via actual pain management and emotional support, but also includes provision of sufficient information and coordinated, integrated care. Additionally, involving the patient and family in decision-making process is essential for the personal values and needs to be emphasized.

There are situations, in which “superior paths” are followed, allowing limited or no possibility for patient preference, such as surgery in the case of acute appendicitis. For the majority of clinical decisions, however, more than one pre-determined treatment path exists and flexibility is demanded when patients express interest in treatment variants. This is especially true in the case of cancer treatment (or the choice not to receive any), heart disease and screening tests for example, in which patient input is of considerable value.

At a health crossroads, the decision-making and the accompanying responsibility become shared, as the clinician, patient and friends or family members can get involved. The clinician provides the attendees with the options and arms them with information on benefits and risks so the patient can highlight their preference.  Decision aids, such as videos or documents, can be provided and which were shown to lead to greater knowledge, more accurate risk perceptions, more decisions aligned with patient values, a reduction in internal conflict and a decrease in indecision.

To cover quality and safety in healthcare in Egypt, the gap between doctors and patients needs to be filled by strengthening mutual relationship and understanding. Patients must recognize their responsibility in studying and understanding treatment options and opt for their most preferred route, while doctors should abandon their paternalism and autonomy and adopt partnership with the patient in his journey.


Shaller, D. Patient-Centered Care: What Does it Take? The Commonwealth Fund, October, 2007.