Shared decision making and the promise of a respectful and equitable healthcare system in Peru

Peru has achieved sustained development in the last two decades. However, despite this achievement, it has not been matched with improvements in the quality of education and health; investment in both sectors is among the lowest in the region. This situation perpetuates huge gaps in infrastructure and also conditions a poor literacy level of the population specifically in health. Currently, there is a fragmented model of patient care, in which the systems are exclusive of each other. They do not cooperate or communicate with each other; and if there is no vertical communication within the system, preventing referral of patients directly from the basic level to the complex level of care when needed. In addition, there has been no progress in the development of an empathetic, respectful or person-centered clinical practice; instead, economic, social and educational differences perpetuate a paternalistic clinical practice. The task of orienting medical training towards the development of humanism is pending. The patient is the center of the medical act and the main objective of doctors’ actions. A humanistic care approach will not only empower the person in the clinical encounter – to participate and make decisions related to his/her health care - but it will allow us to move towards an empathetic, caring, respectful and kind model of clinical practice.