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Wilfred Treasure's review1 of patient-centred diagnosis betrays one of the flaws in the concept of patient centredness. The presence or absence of pathology is a brute biomechanical fact. It is completely independent of any concepts of patient or doctor centredness.
Good communication skills, empathy and shared understanding may make the practice of medicine more patient centred, and may help us to diagnose more effectively, and to make the patient's journey more comfortable. It may also help us guide patients away from investigation when serious pathology is unlikely. However, all of medicine is rooted in pathology and no niceties of communication get us round this. Pathology is centred in the patient, (where else could it be?) and so the act of diagnosis is of necessity both patient centred and patient specific.
All medical knowledge is ultimately derived from patients, and is only of use when used to help patients. Yes some of it may be very technical or scientific, but this does not lessen its dependence on, and centring in, the patients we encounter. Practising medicine well, starting with accurate diagnosis, is actually the most patient-centred act any of us can make.