Recognition of patient expertise can improve adherence
Mary-Clair Yelovich, an M.D. student from Queen's University in Kingston, Canada, addresses patient non-adherence, referring to the ideas of the analogous conflict that may occur within a clinical interaction. Based on the literature relating to recognition of the importance of contributor expertise and interactional expertise in providing legitimate knowledge and the idea of negotiation of meanings as an important aspect of the clinical interaction, the Yelovich discusses resolution of conflicts before they develop into non-adherence.
Yelovich proposed implementation of a new framework that recognizes legitimate knowledge offered by the patient as well as the physician. By placing this framework within the paradigm of patient-centered medicine and by recognizing that the goal of treatment is to treat patient suffering, patient expertise becomes a central means of determining the nature of patient suffering. The body-aspect and meaning-aspect of a patient's tacit knowledge are recognized as essential knowledge for the success of the physician-patient interaction. The physician's role becomes that of medical expert and possessor of interactional expertise.
"By recognizing and incorporating the negotiation of meanings into the development of a treatment plan, this epistemological model of patient expertise should prevent cases of non-adherence based on disagreement," Yelovich writes.
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