Spirituality, Resistance, and Modern Medicine

2017 ◽  
Author(s):  
Jonathan B. Imber
Keyword(s):  
Health Care ◽  
Modern Medicine ◽  
Clinical Encounter ◽  
Systemic Reform ◽  
Public Attention ◽  
Patient Centered ◽  
Medical Encounter ◽  
Health Care Professions ◽  
Patients Experience ◽  
Physician Patient

This is an account of the enduring nature of tensions between patient-centered and social, now global, analyses that reflect the principal interests of sociologists in medicine and the health care professions. System-wide critiques have received the greatest public attention, but at the same time patient-focused accounts of physician-patient interactions offered new ways to account for problems of communication in the medical encounter. The system-wide critiques have increased over the decades, and the systemic reform of health care has become among the most politically controversial subjects in American life. But these debates conceal more than they reveal about transformations in the ways that the clinical encounter has been scrutinized and challenged by a focus on how patients experience illness and how doctors and nurses recognize their responsibilities toward culturally and religiously diverse populations.

scholarly journals Communication as a Key Issue in the Care of Diabetes Mellitus

2015 ◽  
Vol 22 (3) ◽  
pp. 305-310
Author(s):  
Elena-Daniela Grigorescu ◽  
Cristina Mihaela Lăcătuşu ◽  
Gina Eosefina Botnariu ◽  
Raluca Maria Popescu ◽  
Alina Delia Popa ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Medical Care ◽  
Modern Medicine ◽  
Therapeutic Education ◽  
Communicative Interaction ◽  
Patient Centered ◽  
Patient’S Satisfaction ◽  
Communication Techniques ◽  
Physician Patient ◽  
The Impact

Abstract The physician-patient communication has an essential role in establishing and supporting the relationship between these two partners. Moreover, modern medicine highlights the patient-centered approach. Publications assessing the impact of an efficient physicianpatient communication on medical care results in diseases such as diabetes and hypertension have revealed a positive correlation between patient’s satisfaction about the communication with the physician and values of blood pressure, glycated hemoglobin and pain intensity. Interventions needed in both doctors and patients for developing communication abilities were paid special attention in order to achieve an appropriate improvement in their communicative interaction during periodical appointments. In the field of diabetes mellitus, the medical challenge is to improve patients’ knowledge about medical care; this aim is achieved only by therapeutic education, using high-quality communication techniques.

scholarly journals Ethical Philanthropy in the era of Patient-Centric, Value-Based Health Care

2020 ◽  
Vol 8 (3) ◽  
pp. 225-229
Author(s):  
Peter Kalina
Keyword(s):  
Health Care ◽  
Ethical Standards ◽  
Patient Centered ◽  
Research Education ◽  
Innovative Strategies ◽  
Patient Relationships ◽  
Physician Patient ◽  
Influence Behavior ◽  
Support Research ◽  
Care Support

Patient-centered, value-based health care implies care that is high-quality, responsive to patient preferences, delivered safely, and at a fair cost.   The future of healthcare portends changes; including less favorable payer mix, decreased reimbursement and alternate compensation models.  Innovative strategies will be required to maintain excellence in care while efficiently maximizing existing capital and human resources.  Successfully implementing a health care institution’s initiatives cannot be achieved entirely from within.  Philanthropy must fill gaps to help support research, education and clinical missions. Strong physician – patient relationships are essential to facilitating philanthropic gifts from grateful patients. While we assume magnanimous intentions and motivations, gifts may potentially influence behavior.  While VIP care for patients who donated (or believed likely to) is a successful strategy; distinctions are needed between development and clinical relationships.  Philanthropy cannot affect care, which must be irrespective of wealth or position. The highest professional and ethical standards and practices must be maintained when accepting grateful patient philanthropy. Developing and promoting a sustainable philanthropic strategy begins with reviewing needs and goals to support the mission;  motivated and inspired by improving outcomes.  Achieving missions in health care requires dedicated philanthropic partnerships.  Pursued with professionalism, thoughtfulness and integrity; philanthropy represents a vital pathway to innovatively advance patient care.   Support allows donors to make an investment and express their values. Realizing the direct and lasting impact of collaboration provides rewarding benefit and meaningful recognition.

Currents in Contemporary Bioethics

2011 ◽  
Vol 39 (4) ◽  
pp. 690-693 ◽  
Author(s):  
Mark A. Rothstein
Keyword(s):  
Health Care ◽  
Information Technology ◽  
Medical Information ◽  
Clinical Encounter ◽  
Significant Information ◽  
Episode Of Care ◽  
Legal Duty ◽  
Patient Relationships ◽  
Duty To Inform ◽  
Physician Patient

Physicians' duties to their patients traditionally have been construed narrowly in time and scope to focus on the specific episode of care or clinical encounter. Physicians generally have had no ethical or legal duty to notify patients about new medical information discovered after a visit, notwithstanding the health care benefits to patients that might flow from receiving the information. The rule was based on the relatively high burdens that notification would impose on physicians compared with the likelihood of benefits to patients. This established view, however, no longer may be appropriate in light of new physician-patient relationships and the reduced burden of patient notification using new types of health information technology (HIT). This article explores the duty to inform patients and former patients about relevant, medical developments subsequent to their episode of care. It concludes by recommending the recognition in ethics and law of a limited, ongoing duty to notify patients of significant information relevant to their health.

The potential of argumentation theory in enhancing patient-centered care in breaking bad news encounters

2018 ◽  
Vol 7 (2) ◽  
pp. 120-137 ◽  
Author(s):  
Orit Karnieli-Miller ◽  
Galit Neufeld-Kroszynski
Keyword(s):  
Medical Condition ◽  
Treatment Options ◽  
Patient Centered ◽  
Medical Encounter ◽  
Breaking Bad ◽  
Depth Analysis ◽  
Centered Care ◽  
Physician Patient ◽  
Clear Information

Abstract Recent research on medical communication discusses the role of argumentation in building physician-patient consensus to enhance shared decision-making. This paper focuses on the potential of using argumentation to establish the preliminary step of shared understanding of the diagnosis. This understanding is important in helping patients accept the disease and in increasing their involvement in care. We conducted an in-depth analysis of an observation of a medical encounter, triangulated with interviews with all participants, to illustrate how the lack of clear information and argumentation concerning the disease hindered the patient’s understanding and acceptance of it. This in turn led to difficulties in building a trusting relationship and in reaching treatment decisions. We discuss how using argumentation focused on the disease can allow a fruitful patient-centered discussion about the medical condition and treatment options.

The Role of Health System Pharmacy in Improving Influenza Vaccination Rates among Health Care Workers

2011 ◽  
Vol 46 (11) ◽  
pp. 901-904
Author(s):  
Y. Girardot Crystal ◽  
J. Weber Robert
Keyword(s):  
Health Care ◽  
Influenza Vaccination ◽  
Health Care Workers ◽  
Influenza A ◽  
Active Role ◽  
Patient Centered ◽  
Vaccination Rates ◽  
Health Care Professions ◽  
Care Workers ◽  
The Media

The Director's Forum series is written and edited by Robert J. Weber and Scott M. Mark and is designed to guide pharmacy leaders in establishing patient-centered services in hospitals and health systems. During the autumn months, health care professions and the media will advocate for immunizing all patients to prevent the occurrence and spread of influenza. A potential source of influenza in hospitalized patients is health care workers (HCWs) who have not been vaccinated. Pharmacists have long served as vaccine immunizers, advocates, and educators and may play an active role in improving vaccination rates among HCWs. Pharmacy directors should consider their department's role in influenza vaccination by becoming active partners in influenza prevention. By actively participating in making vaccines available in a variety of ways to HCWs, pharmacy directors can maximize the benefits of a hospital's employee vaccination program.

Turning the tables: Using resident physicians’ experiences as patients for leveraging patient-centered care

2018 ◽  
Vol 53 (5-6) ◽  
pp. 405-414
Author(s):  
Mary R Talen ◽  
Jeffrey Rosenblatt ◽  
Christina Durchholtz ◽  
Geraldine Malana
Keyword(s):  
Health Care ◽  
Health Care System ◽  
Urgent Care ◽  
Patient Centered ◽  
Doctor Patient Communication ◽  
Centered Care ◽  
Patient Will ◽  
Physician Role ◽  
Physician Patient ◽  
Care System

Training physicians to become person-centered is a primary goal of behavioral health curriculum. We have curriculum on doctor–patient communication skills and patient narratives to help physicians relate to the patient’s experiences. However, there is nothing more effective than actually being the patient that gives providers an “aha” experience of the patient’s perspective. In this article, we will share personal resident physician-patient stories based on their experiences within acute urgent care, chronic disease management, and routine well health care. In each narrative, the physician-patient will describe how their experiences had an impact in three areas: (1) their professional identity, (2) their connection with patients, and (3) their experience of the health-care system and teams. Drawing from the key emotional and cognitive experiences from these stories, we will identify training strategies that can bridge the personal to professional experiences as a way to enhance person-centered care. Our goal is to use the physician’s insider perspective on the patient experience as a means to augment the awareness of professional physician role, team-based care, and navigating the health-care system.

OP143 Conceptualizing Patients’ Experience With Atrial Fibrillation

2018 ◽  
Vol 34 (S1) ◽  
pp. 52-52
Author(s):  
Elisabeth Oehrlein ◽  
Eleanor Perfetto ◽  
Debbe McCall ◽  
Jennifer Albrecht ◽  
Julia Slejko ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Health Care ◽  
Health Care Providers ◽  
Patient Characteristics ◽  
Care Providers ◽  
Patient Centered ◽  
University Of Maryland ◽  
Selection Of Variables ◽  
The University ◽  
Patients Experience

Introduction:Conceptual models (CMs) are useful tools for researchers and health technology assessment bodies to understand the interplay among environmental characteristics (e.g., health care system), patient characteristics, health behaviors, and patient outcomes. The objective of this pilot study was to elicit perspectives of patients with atrial fibrillation (AF) and health care providers (HCPs) to develop a patient-centered CM of the AF patient experience in a US-based sample.Methods:We developed two preliminary versions of the Andersen model of healthcare utilization (standard and patient-friendly versions) based on the published literature and the help of a patient advisor. For example, instead of describing “predisposing characteristics,” the patient-friendly CM describes, “what is it about me, or other afib patients that could impact disease or outcomes;” “enabling resources” is swapped for “helpful resources,” and “perceived need” is changed to “what impacts whether I believe I need to be treated”. Five patients from an online patient community and 10 HCPs from the University of Maryland Medical System provided feedback on the preliminary models. Audio recordings of interviews were transcribed verbatim, analyzed, and findings incorporated into a revised CM.Results:Interviewee additions under “what impacts whether I believe I need to be treated” included: absence of symptoms and fear of experiencing an AF episode; under “helpful resources” suggested additions include resources for navigating insurer formulary/benefits. Suggested additional outcomes of interest include anxiety, bruising, and shortness-of-breath. While patients found the patient-friendly version easy to understand, HCPs required explanation of standard-version headers, for example ‘predisposing characteristics’ and ‘enabling resources’, which had been adapted in the patient-friendly version.Conclusions:Soliciting input from stakeholders ensures CMs are pragmatic, reflect the real-world experiences of patients and HCPs, and incorporate variables or other considerations not currently described in published literature. Researchers can utilize CMs to aid in selection of variables for observational studies.

scholarly journals Eliciting the Functional Processes of Apologizing for Errors in Health Care

2017 ◽  
Vol 4 ◽  
pp. 233339361769668 ◽  
Author(s):  
Marie M. Prothero ◽  
Janice M. Morse
Keyword(s):  
Health Care ◽  
Essential Elements ◽  
Concept Development ◽  
Physician Patient Relationship ◽  
Patient Centered ◽  
Data Synthesis ◽  
Just Culture ◽  
Centered Care ◽  
Physician Patient ◽  
Response Policy

This article has been awarded GQNR’s Best Paper Award for the 2017 Volume The purpose of this article was to analyze the concept development of apology in the context of errors in health care, the administrative response, policy and format/process of the subsequent apology. Using pragmatic utility and a systematic review of the literature, 29 articles and one book provided attributes involved in apologizing. Analytic questions were developed to guide the data synthesis and types of apologies used in different circumstances identified. The antecedents of apologizing, and the attributes and outcomes were identified. A model was constructed illustrating the components of a complete apology, other types of apologies, and ramifications/outcomes of each. Clinical implications of developing formal policies for correcting medical errors through apologies are recommended. Defining the essential elements of apology is the first step in establishing a just culture in health care. Respect for patient-centered care reduces the retaliate consequences following an error, and may even restore the physician patient relationship.

scholarly journals Family Medicine Ethics:

2018 ◽  
Vol 50 (8) ◽  
pp. 583-588 ◽  
Author(s):  
Marc Tunzi ◽  
William Ventres
Keyword(s):  
Family Medicine ◽  
Medical Ethics ◽  
Ethical Decision Making ◽  
Direct Action ◽  
Reflective Equilibrium ◽  
Family Physicians ◽  
Modern Medicine ◽  
Clinical Encounter ◽  
Patient Centered ◽  
Subjective Data

The practice of modern medical ethics is largely acute, episodic, fragmented, problem-focused, and institution-centered. Family medicine, in contrast, is built upon a relationship-based model of care that is accessible, comprehensive, continuous, contextual, community-focused and patient-centered. “Doing ethics” in the day-to-day practice of family medicine is therefore different from doing ethics in many other fields of medicine, emphasizing different strengths and exemplifying different values. For family physicians, medical ethics is more than just problem solving. It requires reconciling ethical concepts with modern medicine and asking the principal medical ethics question—What, all things considered, should happen in this situation?—at every clinical encounter over the course of the patient-doctor relationship. We assert that family medicine ethics is an integral part of family physicians’ day-to-day practice. We frame this approach with a four-step process modified from other ethical decision-making models: (1) Identify situational issues; (2) Identify involved stakeholders; (3) Gather objective and subjective data; and (4) Analyze issues and data to direct action and guide behavior. Next, we review several ethical theories commonly used for step four, highlighting the process of wide reflective equilibrium as a key integrative concept in family medicine. Finally, we suggest how to incorporate family medicine ethics in medical education and invite others to explore its use in teaching and practice.

scholarly journals Qualifications and Skills Required for Patient Experience Positions

2019 ◽  
Vol 7 (6) ◽  
pp. 1535-1542
Author(s):  
Melanie A Meyer
Keyword(s):  
Health Care ◽  
Customer Service ◽  
Patient Experience ◽  
Health Care Organizations ◽  
Frontline Employees ◽  
Patient Centered ◽  
Key Skills ◽  
Centered Care ◽  
Job Postings ◽  
Patients Experience

The need to provide patient-centered care has been recognized by major players in the health-care field. As such, attention has been placed on patients’ experience of the health care they receive, and health-care organizations have been investing in patient experience initiatives and staffing to implement those initiatives. Given this, the objective for this study was to investigate the qualifications and skills US health-care organizations seek for patient experience positions through a content analysis of job postings. Results show that patient experience positions are largely found in health systems and hospitals. These positions include coordinators, directors, managers, specialists, and advisors. Five key skills were identified: collaborating with stakeholders; coordinating, planning, and executing service excellence programs; handling complaints and grievances; educating and training leadership and frontline employees; and providing excellent customer service. The skills vary depending on the position. The overall goal for patient experience positions is to ensure a complete and positive patient experience. As these patient experience positions are relatively new, requirements will likely evolve over time as organizations adapt patient experience strategies.

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