Towards a new model of the doctor-patient relationship: a challenge starting from the University of Milan.
Gabriella Pravettoni is Professor at the University of Milan, and has, for some years, been working on a new dimension of the doctor-patient relationship. A model which goes beyond the exclusive centrality of the physical dimension of the illness, to focus more closely on how it impacts the individual from emotional, mental and spiritual aspects.
Teaching
Gabriella Pravettoni is Full Professor of Psychology of Decision making in the Department of Oncology and Hemato-oncology (DIPO) at the University of Milan, and deputy director of the same Department. She coordinates the Folsatec(Foundations of the Life sciences, bioethics and cognitive sciences) PhD, at SEMM (European School of Molecular Medicine) in Milan. She is Visiting Professor at King’s College in London, where she collaborates on Medical Decision Making at Guy’s Hospital in London.
She is a member of the scientific board of ecancer – United Kingdom.
Teaching Academic Year 2015-2016:
Psychology of Decision making and Cognitive psychology
Degree Course of Cognitive Science – Department of Oncology and Hemato-oncology (DIPO), University of Milan
Medical Humanities
Oncology Specialty School, National Tumour Institute Milan (hospital affiliated with the University of Milan for the medical training)
Communication and Relation
Degree Course in Medicine and Surgery – Hospital of San Donato and San Paolo Hospital (hospitals affiliated with the University of Milan for the medical training)
Course of Fundamental Human Sciences
Nursing Degree Course – University of Milan
Signs, symptoms and communication
International Medical School – University of Milan
Research
The research activity of the team of Gabriella Pravettoni, carried out both at the University and at the IEO, is particularly centred on medical humanities having as its main emphasis patient empowerment and health, cognitive processes, decision making in medicine and error prevention.
Specifically, the main branches of research are: decision-making processes in medicine, cognitive and psychological mechanisms involved in the development of patient empowerment, the measurement of needs and cancer patients quality of life, the role of heuristics and cognitive bias in the decisional mechanisms of a medical context, the effects of illness on health and on the behavior of patients and their families, and the neurobiological correlates of decision-making processes.
Several international publications (scientific papers, monographs, books) attest to the research work of the team.
Empowerment
Empowerment is one of the main focal points of the research activity of Gabriella Pravettoni, which is both a tool and a means for health promotion. A process whose aim is to strengthen patient’s personal psycho-social resources in disease management and throughout the care pathway, acting on different levels: patient, family, physician, and society.
The World Health Organization has repeatedly stated that patient empowerment promotion is a prerequisite for health, while the current program of community action regarding public health declares that the participation of citizens in decisional processes, represents one of the main values upon which community strategy is based.
It is interesting to note that the Italian National Health Plan has recently introduced the word “empowerment” in documents focused on the planning of new health strategies.
Even though the scientific literature and clinic are unanimous about the efficacy of empowerment, if empowerment is to work it is a fundamental prerequisite that there be an adequate context within which this process can naturally flourish. And this context is the doctor-patient relationship, which should become a positive resource in the care pathway of every patient and every illness.
Physician-Patient: from the University of Milan an innovative educational project
Unfortunately even nowadays, the relationship with a physician is characterized by paternalism which frustrates the awareness and critical spirit of people when they are ill – a time when they need it more than ever. Improving the information exchange with patients about diagnosis, possible treatments, connected risks and benefits, creates the conditions for a physician not to decide for the patient but rather with the patient.
In order to putthis change in perspective, a fundamental role must be played by training, not only of future physicians but also of other health professionals.
In 2014 the Rector of the University of Milan Gianluca Vago, publicly sealed a pact with patients on the occasion of the Congress “100 cum laude – united for patients“.
Soon afterwards, a Chair of Humanity was established at the University of Milan, which introduced into the degree course in medicine, and its oncology specialization, the skills and competence to train physicians to be able to listen to, and interact with, patients in an existential, emotional and social dimension.
The new Department of Oncology and Hemato-oncology of the University of Milan also avails itself of this innovative teaching project. This Department was established in 2015 and it brings together under one roof in a unique single-topic and multi-disciplinary location, the researchers and professors of five oncological university hospitals of Milan, centres of excellence in the Italian and international scene: San Paolo Hospital, Niguarda, Policlinico, the National Tumour Institute, and the European Institute of Oncology.