To practice patient-centered care we need to accept that there will always be someone in the first percentile, just as there will be someone in the 99th percentile. Yet many standardized measures we continue to use depend on the concept of average to define what is normal.
Scores on a normative curve are supposed to inform us about a patient, but they only represent a comparison. What makes more sense is to dispense with looking at people as individuals in a population, and instead look at every client of a “n of 1”. When we make the shift from what is the mean to what does it mean we can better serve the person in front of us