In this vivid talk [start at 5:05], Dr. Victor Montori of the Mayo Clinic tells about what one of his patients must do to address his high blood pressure, diabetes, his weight and the events in his life that compete for his attention.  He describes how guidelines-based care and pay-for-performance incentives inadvertently undermine this patient’s willingness to take action.  And he proposes that clinicians reorganize the care they deliver to 1) take into account the burden of treatment demands; 2) organize care to minimize disruption and 3) order treatment priorities from the patient’s perspective. 

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More on this topic in Patient-Centered Care: From Exam Room to Dinner Table.