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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 -
BMC Palliative Care Apr 2023Nurturing effective physician-patient relationships is essential to the provision of patient-centred care. Palliative care physicians may apply boundary-crossings or...
BACKGROUND
Nurturing effective physician-patient relationships is essential to the provision of patient-centred care. Palliative care physicians may apply boundary-crossings or breaches in professional standards to nurture effective physician-patient relationships. Being highly individualized and shaped by the physician's narratives, clinical experience, and contextual considerations, boundary-crossings are susceptible to ethical and professional violations. To better appreciate this concept, we employ the Ring Theory of Personhood (RToP) to map the effects of boundary-crossings on the physician's belief systems.
METHODS
As part of the Tool Design SEBA methodology, a Systematic Evidence-Based Approach (SEBA) guided systematic scoping review was employed to guide the design of a semi-structured interview questionnaire with palliative care physicians. The transcripts were simultaneously content and thematically analysed. The themes and categories identified were combined using the Jigsaw Perspective and the resulting domains formed the basis for the discussion.
RESULTS
The domains identified from the 12 semi-structured interviews were catalysts and boundary-crossings. Boundary-crossings attempt to address threats to a physician's belief systems (catalysts) and are highly individualized. Employ of boundary-crossings depend on the physician's sensitivity to these 'catalysts', their judgement and willingness to act, and their ability to balance various considerations and reflect on their actions and their ramifications. These experiences reshape belief systems, understandings of boundary-crossings and may influence decision-making and practice, underscoring the potential for greater professional breaches when unchecked.
CONCLUSION
Underlining its longitudinal effects, the Krishna Model underscores the importance of longitudinal support, assessment and oversight of palliative care physicians, and lays the foundation for a RToP-based tool to be employed within portfolios.
Topics: Humans; Palliative Care; Physician-Patient Relations; Physicians; Hospice and Palliative Care Nursing
PubMed: 37055737
DOI: 10.1186/s12904-023-01161-0 -
BMC Medical Research Methodology Oct 2023Physician participation in clinical trials is essential for the progress of modern medicine. However, the demand for physician research partners is outpacing physicians'...
BACKGROUND
Physician participation in clinical trials is essential for the progress of modern medicine. However, the demand for physician research partners is outpacing physicians' interest in participating in scientific studies. Understanding the factors that influence physician participation in research is crucial to addressing this gap.
METHODS
In this study, we used a physician's social network, as constructed from patient billing data, to study if the research choices of a physician's immediate peers influence their likelihood to participate in scientific research. We analyzed data from 348 physicians across 40 hospitals. We used logistic regression models to examine the relationship between a physician's participation in clinical trials and the participation of their social network peers, adjusting for age, years of employment, and influences from other hospital facilities.
RESULTS
We found that the likelihood of a physician participating in clinical trials increased dramatically with the proportion of their social network-defined colleagues at their primary hospital who were participating ([Formula: see text] for a 1% increase in the proportion of participating peers, [Formula: see text]). Additionally, physicians who work regularly at multiple facilities were more likely to participate ([Formula: see text], [Formula: see text]) and increasingly so as the extent to which they have social network ties to colleagues at hospitals other than their primary hospital increases ([Formula: see text], [Formula: see text]). These findings suggest an inter-hospital peer participation process.
CONCLUSION
Our study provides evidence that the social structure of a physician's work-life is associated with their decision to participate in scientific research. The results suggest that interventions aimed at increasing physician participation in clinical trials could leverage the social networks of physicians to encourage participation. By identifying factors that influence physician participation in research, we can work towards closing the gap between the demand for physician research partners and the number of physicians willing to participate in scientific studies.
Topics: Humans; Physicians; Logistic Models; Employment; Social Networking
PubMed: 37898745
DOI: 10.1186/s12874-023-02069-2 -
American Family Physician Dec 2001Breaking bad news is one of a physician's most difficult duties, yet medical education typically offers little formal preparation for this daunting task. Without proper... (Review)
Review
Breaking bad news is one of a physician's most difficult duties, yet medical education typically offers little formal preparation for this daunting task. Without proper training, the discomfort and uncertainty associated with breaking bad news may lead physicians to emotionally disengage from patients. Numerous study results show that patients generally desire frank and empathetic disclosure of a terminal diagnosis or other bad news. Focused training in communication skills and techniques to facilitate breaking bad news has been demonstrated to improve patient satisfaction and physician comfort. Physicians can build on the following simple mnemonic, ABCDE, to provide hope and healing to patients receiving bad news: Advance preparation--arrange adequate time and privacy, confirm medical facts, review relevant clinical data, and emotionally prepare for the encounter. Building a therapeutic relationship-identify patient preferences regarding the disclosure of bad news. Communicating well-determine the patient's knowledge and understanding of the situation, proceed at the patient's pace, avoid medical jargon or euphemisms, allow for silence and tears, and answer questions. Dealing with patient and family reactions-assess and respond to emotional reactions and empathize with the patient. Encouraging/validating emotions--offer realistic hope based on the patient's goals and deal with your own needs.
Topics: Attitude of Health Personnel; Clinical Competence; Emotions; Humans; Patient Satisfaction; Physician's Role; Physician-Patient Relations; Physicians, Family; Terminally Ill
PubMed: 11775763
DOI: No ID Found -
The Kaohsiung Journal of Medical... Jul 2008Physicians are expected to be life-long learners because updated and effective patient care should be provided while medical and clinical knowledge and skills and social... (Review)
Review
Physicians are expected to be life-long learners because updated and effective patient care should be provided while medical and clinical knowledge and skills and social requirements for patient care are rapidly changing. Also, qualified clinical competence needs long periods of training and each physician has to continually learn as long as he/she works as a professional. Self-directed learning is an important factor in adult learning. Medical students' readiness for self-directed learning is not high, and should be improved by medical school and postgraduate training curricula. Garrison proposed a comprehensive model of self-directed learning, and it has dimensions of motivation (entering and task), self-monitoring (responsibility), and self-management (responsibility). To teach individual self-directed learning competencies, the following are important: (1) situate learners to experience "real" problems; (2) encourage learners to reflect on their own performance; (3) create an educational atmosphere in clinical training situations. In 2005, a 2-year mandatory residency program was implemented in Japan, and fewer medical school graduates took residency programs in medical school hospitals and advanced specialty programs provided by medical school departments. Medical school departments provide traditional, but life-long clinical training opportunities. Under the new residency program, an additional postgraduate and continuing medical training system has to be built up to maintain and confirm a physician's competencies. If physicians do clinical work using a scholarly way of thinking with critical analysis of their own competencies and improvement by reflection, they will become an excellent life-long learner.
Topics: Clinical Competence; Curriculum; Education, Medical, Continuing; Humans; Japan; Learning; Motivation; Patient Care; Physicians; Thinking
PubMed: 18805754
DOI: 10.1016/S1607-551X(08)70136-0 -
Indian Heart Journal 2017Medical profession is at cross-roads. On one hand are issues like medical mal-practice and negligence but on the other are loss of respect, low re-imbursement, lawsuits...
Medical profession is at cross-roads. On one hand are issues like medical mal-practice and negligence but on the other are loss of respect, low re-imbursement, lawsuits against medical professionals, violence against physicians all contributing to a lot of stress as also a high suicide rate among medical practitioners. While some of the problems seem related to changing societal norms, most of them seem to stem from a failure, active or passive on the part of medical intellectual, moving away from altruism, justice and self regulation to pursuance of self interest with a consequent loss of trust in doctor-patient relationship. The solution lies not only in regaining this trust by following a path of community welfare, change in medical curriculum but also recognition by society, the problems faced by medical fraternity; long hours, low re-imbursement for mental and physical effort but most importantly loss of prestige. Urgent steps to reverse this malady should be undertaken, otherwise a full-fledged commercial and profit making medical field is the only alternative.
Topics: Humans; India; Physician's Role; Physician-Patient Relations; Physicians; Social Perception; Societies, Medical
PubMed: 28460757
DOI: 10.1016/j.ihj.2017.03.004 -
Annals of Family Medicine 2015In an impoverished outreach clinic in Beirut, a young boy's unique thank you answers a physician's questions about the meaning of her profession.
In an impoverished outreach clinic in Beirut, a young boy's unique thank you answers a physician's questions about the meaning of her profession.
Topics: Child; Humans; Male; Physician's Role; Physician-Patient Relations; Physicians; Smiling
PubMed: 25964411
DOI: 10.1370/afm.1778 -
Journal of Medical Ethics Mar 1982
Topics: Bioethical Issues; Ethical Theory; Ethics, Medical; Germany, West; Humans; Paternalism; Philosophy, Medical; Physician-Patient Relations; Physicians; Sociology, Medical
PubMed: 7069735
DOI: 10.1136/jme.8.1.44 -
Canadian Family Physician Medecin de... Nov 2019
Topics: Canada; Climate Change; Humans; Physician's Role; Physicians, Family
PubMed: 31722896
DOI: No ID Found -
WMJ : Official Publication of the State... Sep 2008
Topics: Family; Female; Humans; Physicians, Women; Self Care; Self Medication
PubMed: 18935897
DOI: No ID Found