Patient-Centeredness during In-Depth Consultation in the Outpatient Clinic of a Tertiary Hospital in Korea: Paradigm Shift from Disease to Patient

Sohn, Kyoung-Hee; Nam, Sarah; Joo, Jungmin; Kwon, Yong Jin; Yim, Jae-Joon

A study on the effect of "in-depth consultations of over 15 minutes" for serious and noncurable diseases was conducted in August 2017, focusing on 1 tertiary hospital. In 2018, it was expanded to include 19 tertiary hospitals across the country. It is remarkable that this project was not a government-led policy; instead, it was a hospital-led pilot project propelled by the awareness of expert groups about the distorted healthcare delivery system. This 6-month study took place in the largest public tertiary hospital in Korea, which exhibited an average consultation time of merely 3.3 minutes for first-time patients. Patients with first-visit consultations for serious and non-curable diseases (four serious diseases: cancer, stroke, coronary artery disease, and rare and intractable disorders defined by regulations) in the outpatient clinic were assigned to an in-depth consultation group or a control group. We aimed to explore the differences in patient-centeredness, willingness to pay, and physician's professionalism with reference to consultation time. system for first-time patients in outpatient clinic based on the willingness of a few physicians to change outpatient clinic behavior and encourage shared decision making. In the previous "15-Minute Consultation" system, patients did not undergo a gate-keeping system and were therefore easily assessable by self-referral. To decrease this behavior, we tightly restricted the patient influx by introducing a gate-keeping system to establish an improved healthcare delivery system and sophisticated outpatient care in tertiary hospitals.