The growing number of web-savvy patients alters the power dynamic in the patient-physician relationship. In the older model of care, physicians served as unchallenged experts who alone devised therapeutic plans for patients.
Society values both the appropriate use of new technological and management innovations and the maintenance of a strong personal and therapeutic relationship between patients and physicians. The medical-home model may be able to accomplish both.
Caregivers often think that so-called “frequent-flyer” patients are at fault for their poor medical outcomes. In many such cases, though, unaddressed psychosocial issues are the root of the patients’ repeat visits to the emergency department.
About 80 percent of children in the ER for suturing preferred a woman doctor; 60 percent of their parents preferred a man, 19 percent, a woman, and 21 percent, the doctor with the most experience.
Awareness of transference reactions, practicing active listening and reflection, pausing, and articulating one’s understanding of another’s emotional motivations can help cultivate deeper patient-clinician relationships at the end of life.
Barriers to effective prognosis conversations include knowledge deficits, misconceptions, cultural differences, and lack of motivation. These can be addressed head-on by good communication interventions.
Does a patient’s request not to have a diagnosis included in her health record undermine a clinician’s capacity to provide clinically and ethically appropriate treatment?
In order to successfully resolve ethical conflicts, bioethics consultants must pay attention to process and heed stakeholders’ perspectives and values.