Primary care, grounded in the provision of continuous comprehensive
person-centred care, is of paramount importance in the delivery of
accessible and effective health care around the world. The central
notion of person-centred care, however, relies on often-unexamined
concepts of self, or understandings of what it means to be a person and
an agent. This cutting-edge book explores contemporary pressures on the
sense of self for both patient and health professional within a
consultation and argues that building new concepts of the self is
essential if we are to reinvigorate the central tenets of person-centred
primary care.
Contemporary trends such as shared decision-making between health
professionals and patients and promoting self-management assume those
involved are able to make their own decisions and take action. In
practice, however, medicine often opts for reductionist perspectives of
patients as passive mechanical systems and diseases as puzzles. At the
same time, huge political and organisational changes mean time and
resources are scarce, putting further pressure on consultations. This
book discusses how we can start to resolve these tensions. The first
part considers problems posed by the increasing bureaucratisation of
primary care, the impact of information technology in the consultation,
the effects of chronic disease on our sense of self and how an emphasis
on biology over biography leads to over-diagnosis. The second part
proposes solutions based on a strong ontology of consciousness, concepts
of creative capacity, coherence and engagement, and will show how these
can enhance the self-esteem of patients and doctors and benefit their
therapeutic dialogue.
Combining theoretical perspectives from philosophy, sociology and
healthcare research with insights drawn from clinical practice, this
edited volume is suitable for those researching and studying primary
healthcare, communication and relationships in heal
