The precarious future of the discourse of person-centered medicine

Abstract

Discourses are more than just patterns of words. For discourse communities, they express ideologies and provide meanings that can be translated into action. They are vehicles for reform when they thrive. The discourse of person-centered medicine has had a vigorous start, with identifiable leaders, a vocabulary which has situated meanings, institutions such as meetings, letterheads and a Society and a group of adherents that constitute a discourse community. For a discourse to thrive, its founding problematic has to be perceived as 'real' by its target audience — in this case, presumably, healthcare workers. Real in this sense can be defined as something perceived to have an influence on foundational values, for better or for worse. It is not yet clear that the discourse of person-centered medicine has convinced its target audience of the 'crisis of knowledge, care, compassion and costs' that it invokes to justify its proposed paradigm shift. In order to make it thrive, those who drive the discourse will need to 'realise' both the crisis it addresses and the outcomes it may achieve. Keywords: Contemporary medicine, discourse, discourse community, entropy, evidence-based medicine, founding problematic, patientcentered care, person-centered medicine, types of discourse