Patient-centred care: the family practice model

The core experience of family practice-the consultation between doctor and patient-is the same for all family physicians, whether they practice in urban, rural or isolated areas. There is not yet a family practice model of this consultation, and the result is wide differences in residency programs' curricula, and residents' perception that their teachers contradict each other. This paper proposes that residents be taught, and practicing family physicians use, a patient-centred method of consultation in which the physician attempts to understand how the patient interprets his illness, as well as to establish the relationship between illness and organic pathology. Two case histories illustrate how this can be done by using open-ended questions and facilitating remarks that encourage the patient to express his feelings.