PATIENT CENTEREDNESS: MEANING AND PROPRIETY IN BOTSWANA AND THE NEED FOR AN AFRICAN MODEL

Patient centeredness is a model of doctor-patient interaction that is founded on research in Europe and the USA. This model strives to ensure that patients’ agendas, feelings and thoughts about their illness are addressed. Enabling doctor-patient relationships that help patients to state their expected outcomes, and to discuss diagnostic and treatment decisions are encouraged. This model enhances patient satisfaction, healing, adherence to treatment, and promotes health seeking behaviour. This Eurocentric model is a social construct and should be appropriate for the context in which it is applied. Patients in Botswana do not seem to fit in this model. Discussing a possible diagnosis or line of treatment with the doctor is difficult for them. This may be due to regional differences in ‘construal of self’, culture and contexts. People in different regions see themselves and the world differently. They understand, feel and act in ways that are congruent with how they fit into their lived contexts. Patient centeredness has a modus operandus and specific meaning as presently understood which may not be appropriate outside of the West. Health workers in different communities should find context-appropriate, evidence-based models of doctor-patient interaction that satisfy their patients. These optimal health interaction models should promote patient satisfying heath delivery in different communities and contexts.