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American Family Physician Jul 2018Delivering serious, bad, or life-altering news to a patient is one of the most difficult tasks physicians encounter. Broadly defined as information that may alter a...
Delivering serious, bad, or life-altering news to a patient is one of the most difficult tasks physicians encounter. Broadly defined as information that may alter a patient's view of his or her future, bad news may include information related to a chronic disease (e.g., diabetes mellitus), a life-altering illness (e.g., multiple sclerosis), or an injury leading to significant change (e.g., a season-ending knee injury). Patients prefer to receive such news in person, with the physician's full attention, and in clear, easy-to-understand language with adequate time for questions. Most patients prefer to know their diagnosis, but the amount of desired details varies among different cultures and by education level, age, and sex. The physician should respect the patient's unique preferences for receiving bad news. Physicians may experience stress related to providing bad news that extends beyond the actual conversation. For example, physicians are afraid of eliciting an emotional reaction, being blamed for the bad news, and expressing their emotions during the process. Physicians often withhold information or are overly optimistic regarding prognosis, but this can lead to confusion for patients regarding their condition. There are several algorithms available to help guide the physician in the delivery of bad news, including the SPIKES protocol (setting, perception, invitation, knowledge, emotion, and strategy and summary). Skillful delivery of bad news can provide comfort for the patient and family.
Topics: Attitude of Health Personnel; Communication; Empathy; Humans; Life Change Events; Patient Preference; Patient Satisfaction; Physician-Patient Relations; Physicians; Prognosis; Truth Disclosure
PubMed: 30215989
DOI: No ID Found -
CMAJ : Canadian Medical Association... Jun 2021
Topics: Attitude to Death; Humans; Physician-Patient Relations; Physicians
PubMed: 34099472
DOI: 10.1503/cmaj.210405 -
International Journal of Environmental... Sep 2019Patient satisfaction is a measure of the extent to which a patient is content with the health care they received from their health care provider. Patient satisfaction is...
Patient satisfaction is a measure of the extent to which a patient is content with the health care they received from their health care provider. Patient satisfaction is one of the most important factors to determine the success of a health care facility. The purpose of this study was to determine patient satisfaction with healthcare services and encompass the physician's behavior as moderation between patient satisfaction and healthcare services. The study seeks to measure the health care services, like a laboratory and diagnostic care, preventive healthcare and prenatal care, to patient satisfaction in the public health sectors of Pakistan. A descriptive survey research design was used for this study. The target population was patients from the out-patient department (OPD) of three public hospitals from Pakistan. By using the convenient sampling technique, 290 sample participants were selected from the target population. The reliability scales were tallied by using Cronbach's Alpha. The findings of the study are gleaned by using regression to explore patient satisfaction with the health care services, and whether or not the physician's behavior moderates the link of patient satisfaction and healthcare services. SPSS Hayes process was used for the moderation effect of the physician's behavior. The main results of the regression analysis validate that health care services, such as laboratory and diagnostic care, preventive healthcare, and prenatal care, have a significant and positive effect on patient satisfaction. Specifically, the study suggests that the physician's behavior significantly moderates the effect of health care services on the satisfaction of patients. The overall opinions about the satisfaction level of patients for the availability of health services in the hospitals were good. The degree of satisfaction was satisfactory with respect to laboratory and diagnostic care, preventive healthcare, and prenatal care services. Based on the outcomes, the study confirms that the proposed hypotheses are statistically significant. Furthermore, the directions for future research of the study are offered.
Topics: Adult; Aged; Aged, 80 and over; Female; Health Services; Hospitals, Public; Humans; Male; Middle Aged; Outpatients; Pakistan; Patient Satisfaction; Physicians; Young Adult
PubMed: 31505840
DOI: 10.3390/ijerph16183318 -
Journal of the American Medical... Jan 2019Across recent decades, profound changes in the practice of medicine have been accompanied by parallel developments in the daily mental efforts of medical professionals....
Across recent decades, profound changes in the practice of medicine have been accompanied by parallel developments in the daily mental efforts of medical professionals. Using visual metaphors and hand-drawn illustrations, the author explores the evolution of one physician's brain over the past 25 years. At the completion of training, the patient-practitioner relationship, medical knowledge, and care decisions dominated clinician thought, time, and effort. During the 1990's, the growing constraints of third-party payers and government regulations presented new challenges to delivering relationship-based care. Over the past decade, the electronic health record (EHR) has added further cognitive complexity, disrupted human relationships, and contributed significantly to the current epidemic of clinician burnout. Solutions to these challenges include rethinking education, documentation, professional standards, institutional barriers, and regulatory mandates. It is important to pursue all solutions with the underlying premise of protecting healing relationships as the foundation of clinical care.
Topics: Electronic Health Records; Humans; Physician-Patient Relations; Physicians; Primary Health Care
PubMed: 30476119
DOI: 10.1093/jamia/ocy144 -
Indian Heart Journal 2018
Topics: Female; Heart Diseases; Humans; Male; Physician's Role; Physicians; Self Care
PubMed: 30392519
DOI: 10.1016/j.ihj.2018.08.014 -
Annals of Family Medicine Nov 2017Hatpins is a first-person narrative that delves into a physician's experience of a patient death during the early years of residency. The essay reflects on the...
Hatpins is a first-person narrative that delves into a physician's experience of a patient death during the early years of residency. The essay reflects on the conflicted physician-patient relationships that can develop even over the short tenure of residency. While residency seeks to create medically prepared and compassionate physicians, this piece speaks to the importance of the often subtle learning that comes from ethical, social, and cultural aspects of both the lives and deaths of our patients.
Topics: Death; Empathy; Humans; Internship and Residency; Physician-Patient Relations; Physicians
PubMed: 29133500
DOI: 10.1370/afm.2135 -
Mayo Clinic Proceedings Jul 2009Although the nature and scope of addictive disease are commonly reported in the lay press, the problem of physician addiction has largely escaped the public's attention.... (Review)
Review
Although the nature and scope of addictive disease are commonly reported in the lay press, the problem of physician addiction has largely escaped the public's attention. This is not due to physician immunity from the problem, because physicians have been shown to have addiction at a rate similar to or higher than that of the general population. Additionally, physicians' addictive disease (when compared with the general public) is typically advanced before identification and intervention. This delay in diagnosis relates to physicians' tendency to protect their workplace performance and image well beyond the time when their life outside of work has deteriorated and become chaotic. We provide an overview of the scope and risks of physician addiction, the challenges of recognition and intervention, the treatment of the addicted physician, the ethical and legal implications of an addicted physician returning to the workplace, and their monitored aftercare. It is critical that written policies for dealing with workplace addiction are in place at every employment venue and that they are followed to minimize risk of an adverse medical or legal outcome and to provide appropriate care to the addicted physician.
Topics: Employment; Humans; Opioid-Related Disorders; Physician Impairment; Physicians; Recovery of Function
PubMed: 19567716
DOI: 10.1016/S0025-6196(11)60751-9 -
Journal of General Internal Medicine Jan 2016
Review
Topics: Clinical Competence; Humans; Interpersonal Relations; Physician-Patient Relations; Physicians
PubMed: 26525383
DOI: 10.1007/s11606-015-3531-z -
Canadian Family Physician Medecin de... Oct 2008
Topics: Attitude of Health Personnel; Codes of Ethics; Health Knowledge, Attitudes, Practice; Human Rights; Humans; Job Satisfaction; Ontario; Physician's Role; Physicians, Family; Refusal to Treat
PubMed: 18854446
DOI: No ID Found -
Advances in Chronic Kidney Disease Nov 2022An integral part of a physician's practice includes being a leader, especially as there is a strong need for skilled leaders to advocate and navigate patient-centered... (Review)
Review
An integral part of a physician's practice includes being a leader, especially as there is a strong need for skilled leaders to advocate and navigate patient-centered and organizational outcomes. Nephrologists undertake multiple leadership roles, but dedicated leadership training is lacking in medical and postgraduate education. Given the growing need for physician leaders, practitioners in nephrology and beyond must become better equipped in understanding the role of leadership skills in medical practice. Nephrology and the medical community as a whole should focus on intentional and dedicated leadership in medical education training to better groom physicians for leadership roles. In this paper, we define and discuss the components and styles of leadership. We further propose cognitive models that allow one to apply leadership theory in common practice.
Topics: Humans; Leadership; Physicians; Education, Medical
PubMed: 36371119
DOI: 10.1053/j.ackd.2022.08.002