196 | nº 30, pp. 187-210 | doxa.comunicación

January-June of 2020

Communicating the humanisation of hospital care. An exercise in social responsibility in Madrid’s hospitals

ISSN: 1696-019X / e-ISSN: 2386-3978

(Byrne and Long, 1984). The group directed by Stewart also understood that the new paradigm, this renewal in the interaction of physicians with patients, would imply a fundamental twist in power relations: “in order to provide a patient centred care, the physician must be able to empower the patient, to share the power in the relationship” (Stewart et al, 2003:5).

In 1995, Stewart published a paper that held the results of research on the physicians-patients community, conducted throughout 25 years. This longitudinal study revealed the problems derived from the lack of transmission of information. On one side, this refers to the information transmitted from patients to doctors, when a physician is drawing up the always essential clinical history of a patient. And on the other side, this also affects the information transmitted from physicians to patients, when a physician is trying to explain a prescription and treatment.

All in all, the studies consulted by Steward stated:

50 percent of psychosocial and psychiatric issues go unnoticed in consultations.

Doctors interrupt patients after 18 seconds, on average, when the latter are explaining their symptoms

54% of the patients’ ailments and 45% of their concerns are not expressed in consultations.

In 50% of cases patients and doctors don’t agree when identifying the essential part of an ailment, and as a conse-quence patients are left unsatisfied (Stewart, 1995: 1429).

It also highlighted the importance of differentiating and exploring separately, on one hand, the disease itself, and on the other, the individual patient’s feelings towards his/her disease. Stewart insists on the importance of patient centred care and highlights its beneficial results: less malpractice complaints, higher satisfaction of physicians, higher satisfaction of patients, better monitoring of treatments, less concerns and better psychological state in patients (Stewart et al, 2003: 14).

Years later, in 2012, Greene, Tuzzio and Churkin conclude that patients that have a good relationship with their physicians undergo less clinical procedures and are less inclined to take legal action in cases of malpractice. And they saw that patient centred care also benefits medical professionals who turn out to be more efficient when treating their patients. These authors also state the need to expand the model of “Patient centred medicine” to other relations in the health care environment, so that it is not limited to the relationship doctor-patient, but rather broadened in its application to any type of interpersonal relationship in the health care area, be it in primary care, at the hospital or in any other scenario within the health care system.

4. The Humanisation Plan of the Community of Madrid

The General Health Law of April 25th, 1986 established a national health system in Spain that integrated the different public health networks existing until then. This law established the universality of health care for Spanish citizens and residents, and it determined a decentralized system in autonomous communities.