Collaborative domestication

2022 ◽  
Vol 37 (71) ◽  
pp. 224-244
Author(s):  
Elle Christine Lüchau ◽  
Anette Grønning
Keyword(s):  
General Practice ◽  
General Practitioner ◽  
Mutual Influence ◽  
Patient Relationship ◽  
Doctor Patient Relationship ◽  
Daily Lives ◽  
Future Studies ◽  
Technology Users ◽  
Patients Experience ◽  
Domestication Theory

This article proposes an extension to domestication theory by introducing the concept of collaborative domestication, which we define as the ongoing mutual influence and interdependence of technology users in specific interactional contexts. This concept arose from our investigation of how patients integrate healthcare-related video consultations into their daily lives. In Denmark, the Covid-19 pandemic has expedited the implementation of video consultations in general practice, yet little is known about their use in this context. To address this, we conducted 13 interviews with patients and analysed the interviews from the perspective of domestication theory. We find that the general practitioner plays a central role throughout patients’ domestication processes, and the doctor–patient relationship significantly influences how patients experience video consultations. We argue that there is a collaborative aspect to domesticating video consultations that needs to be considered in both future studies and the ongoing implementation of video consultations

The General Practitioner and the Patient with Backache

1974 ◽  
Vol 5 (3) ◽  
pp. 243-252 ◽  
Author(s):  
Leon Chertok ◽  
Odile Bourguignon ◽  
Louis Velluet
Keyword(s):  
General Practice ◽  
General Practitioner ◽  
Patient Relationship ◽  
Doctor Patient Relationship ◽  
Difficult Challenge

Patients with backache often present a difficult challenge for the physician, who often experiences feelings of helplessness in treating the pain. Reported here are discussions centering around different backache cases met in general practice, focusing particularly on the therapeutic difficulties encountered and the resistance to establishing a deep doctor-patient relationship. Recommendations are made for modifying certain medical attitudes, and reconciling physicians to their inevitable therapeutic limitations in such cases.

PRELIMINARY ASSESSMENT OF GPS' KNOWLEDGE AND ATTITUDE ABOUT PERSON CENTRED CARE

2018 ◽  
Vol 28 (2) ◽  
pp. 567-570
Author(s):  
Radost Assenova ◽  
Levena Kireva ◽  
Gergana Foreva
Keyword(s):  
General Practice ◽  
Patient Empowerment ◽  
Patient Relationship ◽  
Preliminary Assessment ◽  
Doctor Patient Relationship ◽  
Patient Centered ◽  
Term Care ◽  
Family Doctors ◽  
Person Centered Care ◽  
Centered Care

Introduction: The European definition of WONCA of general practice introduces the determinant elements of person-centered care regarding four important, interrelated characteristics: continuity of care, patient "empowerment", patient-centred approach, and doctor-patient relationship. The application of person-centred care in general practice refers to the GP's ability to master the patient-centered approach when working with patients and their problems in the respective context; use the general practice consultation to develop an effective doctor–patient relationship, with respect to patient’s autonomy; communicate, set priorities and establish a partnership when solving health problems; provide long-lasting care tailored to the needs of the patient and coordinate overall patient care. This means that GPs are expected to develop their knowledge and skills to use this key competence. Aim: The aim of this study is to make a preliminary assessment of the knowledge and attitudes of general practitioners regarding person-centered care. Material and methods: The opinion of 54 GPs was investigated through an original questionnaire, including closed questions, with more than one answer. The study involved each GP who has agreed to take part in organised training in person-centered care. The results were processed through the SPSS 17.0 version using descriptive statistics. Results: The distribution of respondents according to their sex is predominantly female - 34 (62.9%). It was found that GPs investigated by us highly appreciate the patient's ability to take responsibility, noting that it is important for them to communicate and establish a partnership with the patient - 37 (68.5%). One third of the respondents 34 (62.9%) stated the need to use the GP consultation to establish an effective doctor-patient relationship. The adoption of the patient-centered approach at work is important to 24 (44.4%) GPs. Provision of long-term care has been considered by 19 (35,2%). From the possible benefits of implementing person-centered care, GPs have indicated achieving more effective health outcomes in the first place - 46 (85.2%). Conclusion: Family doctors are aware of the elements of person-centered care, but in order to validate and fully implement this competence model, targeted GP training is required.

A comparative study of teleconsultations versus face-to-face consultations

2001 ◽  
Vol 7 (5) ◽  
pp. 257-265 ◽  
Author(s):  
E J Nordal ◽  
D Moseng ◽  
B Kvammen ◽  
M-L Løchen
Keyword(s):  
General Practitioner ◽  
Comparative Study ◽  
Complete Agreement ◽  
Patient Relationship ◽  
Doctor Patient Relationship ◽  
Partial Agreement ◽  
Face To Face ◽  
High Degree ◽  
Made In

We compared the diagnoses made by one dermatologist via telemedicine with those of another dermatologist made in a face-to-face consultation. The patients first underwent a teledermatology consultation and then a face-to-face consultation. A general practitioner was present with the patient in the videoconference studio. Videoconferencing equipment connected at 384 kbit/s was used. The doctor-patient relationship and the satisfaction of the patients and dermatologists in the two settings were assessed, as well as technical conditions during the videoconferences. There were 121 patients, with a mean age of 40 years (range 17-82 years). There was a high degree of concordance between the two sets of diagnoses, with 72% complete agreement and 14% partial agreement between the two dermatologists. A total of 116 patients (96% of those included) completed a questionnaire. Both the patients and the dermatologists were in general satisfied with the videoconferences. Videoconferencing with a participating general practitioner may be useful in dermatology, but the technique should be used only for selected patients.

scholarly journals Perceived doctor-patient relationship and satisfaction with general practitioner care in older persons in residential homes

2018 ◽  
Vol 36 (2) ◽  
pp. 189-197 ◽  
Author(s):  
Claudia S. de Waard ◽  
Antonius J. Poot ◽  
Wendy P. J. den Elzen ◽  
Annet W. Wind ◽  
Monique A. A. Caljouw ◽  
...  
Keyword(s):  
General Practitioner ◽  
Older Persons ◽  
Patient Relationship ◽  
Doctor Patient Relationship ◽  
Residential Homes ◽  
General Practitioner Care

The Doctor-Patient Relationship as a Diagnostic Tool

1972 ◽  
Vol 3 (4) ◽  
pp. 343-355 ◽  
Author(s):  
Max B. Clyne
Keyword(s):  
General Practice ◽  
Structure And Function ◽  
Diagnostic Process ◽  
Abstract Concept ◽  
Patient Relationship ◽  
Doctor Patient Relationship ◽  
Statistical Probability ◽  
Objective Observer ◽  
The Individual ◽  
And Function

Diagnosis is possible on a number of levels. Traditional, overall, and interrelationship types of diagnosis are differentiated. The effectiveness of the traditional diagnosis, which is used to indicate etiology of disease, to assess the effect of the disorder on structure and function, and to classify the illness, is questioned, since it usually leads to a general prognosis based on statistical probability rather than to a unique prognosis indicating specific predictions and treatments for the individual patient. The doctor, when making this kind of diagnosis, acts as an objective observer and assesses an abstract concept, the illness rather than a person, so that the traditional diagnosis is illness-centered. By including features of the patient's personality and his relationships with others, the overall diagnosis provides a more embracing overview of the individual's physical and emotional conditions. It has greater ongoing validity in description and of usefulness for treatment by centering upon the patient as an individual whose conflicts and sufferings are felt and understood. It may require lengthy interviewing, but this may be shortened in practice by focusing upon the particular aspect of the patient's world which seems central to the pathology. This focal area is often determined spontaneously through a “flash,” the mutual intuitive recognition of an important understanding between doctor and patient, leading to further diagnostic and therapeutic work. The flash establishes a climate of high emotional charge and involves both patient and doctor intrinsically in the diagnostic process and its outcome. It is one of the means by which an interrelationship diagnosis, centered on the doctor-patient relationship, may be arrived at. Truly successful treatment in general practice, and perhaps in most branches of medicine, is probably based on some form of interrelationship diagnosis, even though this diagnosis may not have been verbalized or properly conceptualized by the doctor. Case material illustrates the effectiveness of each type of diagnosis for the physician and for his patient.

scholarly journals Attachment in the doctor–patient relationship in general practice: A qualitative study

2010 ◽  
Vol 28 (3) ◽  
pp. 185-190 ◽  
Author(s):  
Heidi Bøgelund Frederiksen ◽  
Jakob Kragstrup ◽  
Birgitte Dehlholm-Lambertsen
Keyword(s):  
General Practice ◽  
Qualitative Study ◽  
Patient Relationship ◽  
Doctor Patient Relationship

scholarly journals The Concept of Minimalist Interventions in General Medicine: Minimum Means, Maximum Effect

2019 ◽  
Vol 2 (1) ◽  
pp. 01-06
Author(s):  
Jose Luis Turabian
Keyword(s):  
General Practitioner ◽  
Large Scale ◽  
Low Cost ◽  
General Medicine ◽  
Medical Intervention ◽  
Maximum Effect ◽  
Patient Relationship ◽  
Doctor Patient Relationship ◽  
Less Is More ◽  
The Impact

Practical work requires deepening in the theory. In this way, the intention of this article is to systematize the concept of "minimal interventions", as well as draw attention to the impact that this type of interventions of the general practitioner can have on the patient, however small and insignificant, their action may seem. The doctor-patient relationship creates contexts that act, in one way or another, on the patient. There is no absence of medical intervention, even when there is no conscious intervention of the doctor on the patient. Non-intervention is a type of intervention. Non-intervention is a bio-fiction. The different types of doctor-patient relationship give rise, naturally, perhaps imperceptibly, to different models of educational intervention. In this scenario, a conceptualization and systematization of the "micro-interventions" in general medicine is presented: minimal, imperceptible, briefs, low cost, zen, human size, opportunistic, small and mild, but continuous interventions. These micro-interventions are cost-effective no matter how small and insignificant their action seems. These minimal interventions of the general practitioner are of great importance and constitute an updated form of the "less is more" rationalist, they express the power of the minimum gesture in general / family medicine, and can transform health / disease on a large scale. In this way we can hypothesize a plausible relationship between the minimal but concentrated and powerful means, that is to say "contextualized", and the intensity of the effect in general medicine. The clarity of the reading of a message depends on the appreciation of the context; what counts is not what, but how. The context highlights or "pulls" the message. Many small people, in small places, doing small things, can change the world.

Psychiatry and the Role of the General Practitioner

1972 ◽  
Vol 3 (4) ◽  
pp. 287-301 ◽  
Author(s):  
E. D. Wittkower ◽  
W. J. Stauble
Keyword(s):  
General Practitioner ◽  
Medical Profession ◽  
Physical Illness ◽  
Wide Field ◽  
Patient Relationship ◽  
Doctor Patient Relationship ◽  
Balint Groups ◽  
Whole Person ◽  
Emotional Conflicts

The psychiatric role of the general practitioner covers a wide field and depends crucially upon his efforts to understand himself, his patient, and the doctor-patient relationship. The patient must be approached in terms of how he is affected emotionally by physical illness, and how his state of physical health is affected by his emotions. His behavior during initial stages of physical illness, his reaction to the diagnosis, and his feelings and interactions during the full-blown stages of illness are important areas for the doctor to explore in order to deal more effectively with a patient's withdrawal, depression, narcissism, frustration, or anxiety. The doctor must also explore his own motivations for choosing the medical profession in order to implement his role in caring for patients. Each of the models of the doctor-patient relationship–activity-passivity, guidance-cooperation, mutual participation-requires different degrees of emotional involvement on the part of the doctor. An understanding of the psychodynamics of this relationship, involving the attitudes and conflicts of both members, can help the general practitioner to handle effectively and successfully his patients in everyday practice. Practical suggestions are made for teaching psychological concepts to general physicians: improved courses in psychiatry in medical schools, emphasizing the “whole person” approach; ongoing seminars for doctors in practice–“Balint Groups”–in which the aim is to understand the nature of the patient's emotional conflicts, the doctor-patient relationship, and the part the doctor plays in it; refresher courses; and consultations with psychiatrists.

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