Reimagining Our Relationships with Patients: A Perspective from the Keystone IV Conference

Larry A. Green; James C. Puffer

doi:10.3122/jabfm.2016.S1.160152

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Figure 1.
Keystone IV group photo.

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Table 1.

Promises of the Personal Physician from Keystone IV

Etz	I will be held accountable to those who need me. I will be there for you. Attentive and fully present. I will care for you when you have no need and you do not ask. I will center that care in your lived experience of health and illness, knowing you over time. I will be here for you now, over time and across distance, in ways that foster the feeling of wholeness and belonging. I will provide centered care, personal care, expert care, and experiential care, despite economic, technological, and political distractions that threaten to enter the healing place we create together. Because I know you, I will be able to use the best knowledge, best tailored to meet our shared understanding of your goals and aspirations.
Miller	We promise to always be present, as clinically competent partners, and work with you, your family and friends, and our communities for better health. It is a collective promise by our personal, relationship-centered team. My individual promise is to ensure the collective one. This is a dream that will not sleep; a promise we will keep. This is the hunger we will fulfill.
Griswold	Wherever care is delivered, we can promise to meet and delight in patients where they are; continue to cultivate communities of solution; remember the place of touch in healing.
Loxterkamp	Let's pledge to give patients our undivided time. Let's create treatment plans that are built on the bedrock of trust. And let's secure these promises with a commitment to regain control over our professional time and the rule by which we govern it.
Stream et al	We must also renew promises: our promise to maintain a broad scope of training and practice for family physicians to meet patient and community needs; our promise to collaborate with other primary care professionals and stakeholders outside of medicine; our promise to embrace patients and patient advocates as partners in our work at the patient/organizational/systems levels; and our promise to be leaders in our communities with regard to bridging public and behavioral health.
Waters et al	First and foremost, we will be unwavering in our commitment to relationship, to flatten the power differential between patient and health team, and to be present especially at those critical transitions of care when our patients need us most. We will also remember that our purpose as healers and our commitment to the whole patient includes a call to action outside our clinics. We promise to advocate for relationship-centered care for all as the foundation for a new health care system. Inherent in this goal is working toward universal access to health care, so that those currently unable to establish a relationship with a health team can do so. Innovations at the clinic and system levels that enhance accessibility, continuity, and coordination of care will ultimately enhance the strength of patient-care team relationships. We also acknowledge our mandate to bear witness to the powerful impact of the social, economic, and political determinants of health, to persistent institutional racism, and to unique hardships faced by those new to this country.
Schroeder	I will work with you to maximize your health and well-being. I will try to get to know you and understand what you want from me. I will try to meet your needs, including sites of care. I or one of my team members will be available for you.