Two points strike me as foundational for making sense of patient-centered care (“PCC”). First, PCC stands for something everyone wants; like Santa Claus or democracy, PCC is a promise of good things. Second, what any particular person, group, or institution wants under the rubric of PCC varies enormously. There are certainly common themes among different versions of PCC—one would be increased patient input in treatment decisions; another would be physicians taking a more holistic attitude toward patients, as opposed to medicine reducing the patient to a site of pathology. But as I read the PCC literature and listen to various groups formulate their version of practicing PCC, variation impresses me more than commonalities. Thus, any attempt to define PCC risks obscuring what is most interesting about it, which is how PCC works as a signifier—a linguistic sign—onto which an extraordinary range of personal and institutional hopes and fears can be projected, or may be dumped. The question of PCC is what work this sign will do for whom: whose interests will be advanced by PCC, and which interests may end up being subordinated?
