Literature DB >> 22943560

Creating an impersonal NHS? Personalization, choice and the erosion of intimacy.

John Owens1.   

Abstract

BACKGROUND: Personalization - most often understood in terms of granting patients greater opportunity to participate in, and make choices about, the services they receive - has become a key principle guiding reform of the English NHS.
OBJECTIVE: This study sets out to explore the relationship between two senses of the term 'personal' within the context of personalization. Firstly, much of the policy literature equates a 'personal' service with one that is responsive to the choices of individual patients. Secondly, the term 'personal' can be thought to refer to the intimate relationships between patients and medical professionals that have typified traditional models of good practice. METHODOLOGY AND DISCUSSION: I combine a review of the relevant academic and policy literature on personalization with a process of conceptual analysis to uncover three arguments, which suggest that personalization based on choice may adversely affect standards of care by eroding the qualities of intimacy at the heart of the care process. Thus, an unintended consequence of the drive for personalization may be the creation of an NHS that is, in an important sense, less personal than it once was.
CONCLUSION: Whilst personalization may deliver many potential benefits, the tension between promoting patient choice and retaining intimate professional-patient relationships ought to be taken seriously. Thus, the task of promoting choice whilst retaining intimacy represents a key policy challenge for advocates of personalization.
© 2012 John Wiley & Sons Ltd.

Entities:  

Keywords:  NHS reform; co-production; consumer; direct payments; doctor-patient relationship; intimacy; patient choice; patient-centred; personal budgets; personalization

Mesh:

Year:  2012        PMID: 22943560      PMCID: PMC5060756          DOI: 10.1111/hex.12000

Source DB:  PubMed          Journal:  Health Expect        ISSN: 1369-6513            Impact factor:   3.377


  9 in total

1.  The death of the personal doctor.

Authors:  R Adam; B Guthrie
Journal:  J Health Serv Res Policy       Date:  2001-07

2.  Proposed changes for nurse education in England (UK) as a result of the Darzi report (DoH, 2008a) Health Quality Care for All--NHS next stage review final report: some initial observations.

Authors:  Karen Holland
Journal:  Nurse Educ Pract       Date:  2008-09       Impact factor: 2.281

3.  In defense of paternalism.

Authors:  Erich H Loewy
Journal:  Theor Med Bioeth       Date:  2005

4.  Death of the personal doctor.

Authors:  J McCormick
Journal:  Lancet       Date:  1996-09-07       Impact factor: 79.321

5.  Public management 'reform' narratives and the changing organisation of primary care.

Authors:  Ewan Ferlie
Journal:  London J Prim Care (Abingdon)       Date:  2010-12

6.  Whatever suits you: unpicking personalization for the NHS.

Authors:  Alan Cribb; John Owens
Journal:  J Eval Clin Pract       Date:  2010-04       Impact factor: 2.431

7.  The educational needs of the future general practitioner.

Authors: 
Journal:  J R Coll Gen Pract       Date:  1969-12

8.  The key to personal care.

Authors:  D J Gray
Journal:  J R Coll Gen Pract       Date:  1979-11

9.  Purposes of medicine.

Authors:  T Fox
Journal:  Lancet       Date:  1965-10-23       Impact factor: 79.321

  9 in total

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