Evidence-Based, Patient-Centered Care in Action: Clinical Case Report

This clinical case report illustrates the application of the evidence-based, patient-centered model of care, emphasizing the necessary integration of the best available literature, clinical expertise, and respect for the patient’s wants and needs. The patient was a 44-year-old female presenting with chronic neck pain and cervicogenic vertigo (dizziness upon head movement), symptoms that began 15 years after a whiplash injury. Objective findings included reduced and painful cervical range of motion, radiating pain upon compression, and somatosensory signs. Based on clinical expertise and the chronicity of the injury, the assessment included suspected cervical cord compression and cervical degenerative changes, justifying orders for a Davis series and MRI to rule out instability. The critical moment arose when the patient explicitly stated she was afraid of and did not want her neck adjusted due to a negative past experience. The author highlights that even if clinical findings supported high-velocity, low-amplitude manipulation, the absence of informed consent—which requires explaining procedures, diagnoses, and outcomes—precludes such treatment. Therefore, the recommended treatment was gentle cervical distraction and soft-tissue work to align with the patient-centered paradigm.