In Search of Excellence. Expanding the Patient-centred Clinical Method: a Three-stage Assessment

Excellence in caring for the patient has been pursued in bettertechnology and better management structures with multidisciplinaryteams. Excellence is increasingly sought through taking thewhole person seriously and in developing better ways of workingwith relationships. This paper traces the growth of ideas andtheir application in a university department of family medicine,toward a holistic and more patient-centred, three-stage clinicalmethod. This three-stage assessment helps the patient and thephysician to deal holistically with the problem. The biological,the psychological and the environmental systems as well as theirinterrelationships are considered as they impact on health andillness. This method of arriving at a ‘best-fit’understanding of a person's problem, by the doctor and the patienttogether, helps to individualize the assessment and management.Excellence is more likely to be found when we care in an individualizedway within a systems understanding.